Does N-Terminal Pro-B-Type Natriuretic Peptide Improve the Risk Stratification of Emergency Department Patients With Syncope?

Methodology: 4/5 Usefulness: 3/5 Thiruganasambandamoorthy V, et al. Ann Intern Med. 2020 May 19;172(10):648-655. Methods: Prospective cohort study to evaluate whether adding NT-proBNP to the CSRS improves prediction of 30-day SAEs. Findings: Adding NT-proBNP provided no additional benefit to the model and would result in 10% of patients being correctly reclassified and 8.7% of patients being incorrectly reclassified in terms […]

Multicenter Emergency Department Validation of the Canadian Syncope Risk Score

Methodology: 4.5/5 Usefulness: 4.5/5 Thiruganasambandamoorthy V, et al. JAMA Intern Med. 2020 Mar 23;180(5):1-8.  Question and Methods: Prospective cohort validation to predict 30-day serious outcomes among ED patients with syncope Findings: 3819 patients had an overall 3.6% serious event rate at 30-days. At a score of -1, the CSRS had a Sn/Sp/NPV of 97.8%/44.3%/100% Limitations: Overlap in recruitment sites and […]

Canadian Syncope Risk Score – Duration of Cardiac Monitoring

Syncope constitutes 1% of Emergency Department (ED) visits, and approximately 10% of these patients will have serious underlying conditions causing syncope (arrhythmia, MI, serious structural heart disease, pulmonary embolism, subarachnoid or severe hemorrhage). Alarmingly, half to one-third of these serious conditions will not be identified during ED evaluation. We previously derived the Canadian Syncope Risk Score to predict the probability of serious […]

Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope.

Journal Club Summary Methodology Score: 4.5/5                 Usefulness Score: 4/5   Thiruganasambandamoorthy V, et al. CMAJ. 2016 Sep 6;188(12):E289-98 Full Article   This large multicenter prospective ED syncope study derived a methodologically robust risk tool for prediction of 30-day serious adverse events after ED disposition. This risk score will aid in ED management of patients: those at higher-risk require further management (thorough […]

The Canadian Syncope Risk Score

Syncope is an commonly encountered problem in Emergency Medicine, with the potential for significant morbidity and mortality to patients. Unfortunately, to date, there have not been any reliable decision tools or instruments to help us in our assessment of the syncope patient.  This week, Venkatesh Thiruganasambandamoorthy and colleagues at the Ottawa Hospital have published an new Canadian Syncope Risk Score to identify patients […]

Accuracy and Quality of Clinical Decision Rules for Syncope in the Emergency Department: A Systematic Review and Meta-analysis

  Journal Club Summary Methodology:  4/5          Usefulness:  2.5/5 Serrano LA, Hess EP, Bellolio MF, Murad MH, Montori VM, Erwin PJ, Decker WW. Ann Emerg Med. 2010 Oct;56(4):362-373 Abstract Link   This systematic review and meta-analysis of multiple clinical decision rules for syncope, found the pooled sensitivity and specificity for the only 2 externally validated rules (SFSR and OESIL) were lower […]