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Prospective validation of prognostic and diagnostic syncope scores in the emergency department

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Prospective validation of prognostic and diagnostic syncope scores in the emergency department. / du Fay de Lavallaz, Jeanne; Badertscher, Patrick; Nestelberger, Thomas; Isenrich, Rahel; Miró, Òscar; Salgado, Emilio; Geigy, Nicolas; Christ, Michael; Cullen, Louise; Than, Martin; Martin-Sanchez, F Javier; Bustamante Mandrión, José; Di Somma, Salvatore; Peacock, W Frank; Kawecki, Damian; Boeddinghaus, Jasper; Twerenbold, Raphael; Puelacher, Christian; Wussler, Desiree; Strebel, Ivo; Keller, Dagmar I; Poepping, Imke; Kühne, Michael; Mueller, Christian; Reichlin, Tobias; Giménez, Maria Rubini; Walter, Joan; Kozhuharov, Nikola; Shrestha, Samyut; Mueller, Deborah; Sazgary, Lorraine; Morawiec, Beata; Muzyk, Piotr; Nowalany-Kozielska, Ewa; Freese, Michael; Stelzig, Claudia; Meissner, Kathrin; Kulangara, Caroline; Hartmann, Beate; Ferel, Ina; Sabti, Zaid; Greenslade, Jaimi; Hawkins, Tracey; Rentsch, Katharina; von Eckardstein, Arnold; Buser, Andreas; Kloos, Wanda; Lohrmann, Jens; Osswald, Stefan; BASEL IX Investigators.

in: INT J CARDIOL, Jahrgang 269, 15.10.2018, S. 114-121.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

du Fay de Lavallaz, J, Badertscher, P, Nestelberger, T, Isenrich, R, Miró, Ò, Salgado, E, Geigy, N, Christ, M, Cullen, L, Than, M, Martin-Sanchez, FJ, Bustamante Mandrión, J, Di Somma, S, Peacock, WF, Kawecki, D, Boeddinghaus, J, Twerenbold, R, Puelacher, C, Wussler, D, Strebel, I, Keller, DI, Poepping, I, Kühne, M, Mueller, C, Reichlin, T, Giménez, MR, Walter, J, Kozhuharov, N, Shrestha, S, Mueller, D, Sazgary, L, Morawiec, B, Muzyk, P, Nowalany-Kozielska, E, Freese, M, Stelzig, C, Meissner, K, Kulangara, C, Hartmann, B, Ferel, I, Sabti, Z, Greenslade, J, Hawkins, T, Rentsch, K, von Eckardstein, A, Buser, A, Kloos, W, Lohrmann, J, Osswald, S & BASEL IX Investigators 2018, 'Prospective validation of prognostic and diagnostic syncope scores in the emergency department', INT J CARDIOL, Jg. 269, S. 114-121. https://doi.org/10.1016/j.ijcard.2018.06.088

APA

du Fay de Lavallaz, J., Badertscher, P., Nestelberger, T., Isenrich, R., Miró, Ò., Salgado, E., Geigy, N., Christ, M., Cullen, L., Than, M., Martin-Sanchez, F. J., Bustamante Mandrión, J., Di Somma, S., Peacock, W. F., Kawecki, D., Boeddinghaus, J., Twerenbold, R., Puelacher, C., Wussler, D., ... BASEL IX Investigators (2018). Prospective validation of prognostic and diagnostic syncope scores in the emergency department. INT J CARDIOL, 269, 114-121. https://doi.org/10.1016/j.ijcard.2018.06.088

Vancouver

du Fay de Lavallaz J, Badertscher P, Nestelberger T, Isenrich R, Miró Ò, Salgado E et al. Prospective validation of prognostic and diagnostic syncope scores in the emergency department. INT J CARDIOL. 2018 Okt 15;269:114-121. https://doi.org/10.1016/j.ijcard.2018.06.088

Bibtex

@article{7322dbbcf2504fb78860882c0712aad7,
title = "Prospective validation of prognostic and diagnostic syncope scores in the emergency department",
abstract = "BACKGROUND: Various scores have been derived for the assessment of syncope patients in the emergency department (ED) but stay inconsistently validated. We aim to compare their performance to the one of a common, easy-to-use CHADS2 score.METHODS: We prospectively enrolled patients ≥ 40 years old presenting with syncope to the ED in a multicenter study. Early clinical judgment (ECJ) of the treating ED-physician regarding the probability of cardiac syncope was quantified. Two independent physicians adjudicated the final diagnosis after 1-year follow-up. Major cardiovascular events (MACE) and death were recorded during 2 years of follow-up. Nine scores were compared by their area under the receiver-operator characteristics curve (AUC) for death, MACE or the diagnosis of cardiac syncope.RESULTS: 1490 patients were available for score validation. The CHADS2-score presented a higher or equally high accuracy for death in the long- and short-term follow-up than other syncope-specific risk scores. This score also performed well for the prediction of MACE in the long- and short-term evaluation and stratified patients with accuracy comparative to OESIL, one of the best performing syncope-specific risk score. All scores performed poorly for diagnosing cardiac syncope when compared to the ECJ.CONCLUSIONS: The CHADS2-score performed comparably to more complicated syncope-specific risk scores in the prediction of death and MACE in ED syncope patients. While better tools incorporating biochemical and electrocardiographic markers are needed, this study suggests that the CHADS2-score is currently a good option to stratify risk in syncope patients in the ED.TRIAL REGISTRATION: NCT01548352.",
keywords = "Aged, Aged, 80 and over, Electrocardiography/methods, Emergency Service, Hospital/standards, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Syncope/diagnosis",
author = "{du Fay de Lavallaz}, Jeanne and Patrick Badertscher and Thomas Nestelberger and Rahel Isenrich and {\`O}scar Mir{\'o} and Emilio Salgado and Nicolas Geigy and Michael Christ and Louise Cullen and Martin Than and Martin-Sanchez, {F Javier} and {Bustamante Mandri{\'o}n}, Jos{\'e} and {Di Somma}, Salvatore and Peacock, {W Frank} and Damian Kawecki and Jasper Boeddinghaus and Raphael Twerenbold and Christian Puelacher and Desiree Wussler and Ivo Strebel and Keller, {Dagmar I} and Imke Poepping and Michael K{\"u}hne and Christian Mueller and Tobias Reichlin and Gim{\'e}nez, {Maria Rubini} and Joan Walter and Nikola Kozhuharov and Samyut Shrestha and Deborah Mueller and Lorraine Sazgary and Beata Morawiec and Piotr Muzyk and Ewa Nowalany-Kozielska and Michael Freese and Claudia Stelzig and Kathrin Meissner and Caroline Kulangara and Beate Hartmann and Ina Ferel and Zaid Sabti and Jaimi Greenslade and Tracey Hawkins and Katharina Rentsch and {von Eckardstein}, Arnold and Andreas Buser and Wanda Kloos and Jens Lohrmann and Stefan Osswald and {BASEL IX Investigators}",
note = "Copyright {\textcopyright} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
month = oct,
day = "15",
doi = "10.1016/j.ijcard.2018.06.088",
language = "English",
volume = "269",
pages = "114--121",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Prospective validation of prognostic and diagnostic syncope scores in the emergency department

AU - du Fay de Lavallaz, Jeanne

AU - Badertscher, Patrick

AU - Nestelberger, Thomas

AU - Isenrich, Rahel

AU - Miró, Òscar

AU - Salgado, Emilio

AU - Geigy, Nicolas

AU - Christ, Michael

AU - Cullen, Louise

AU - Than, Martin

AU - Martin-Sanchez, F Javier

AU - Bustamante Mandrión, José

AU - Di Somma, Salvatore

AU - Peacock, W Frank

AU - Kawecki, Damian

AU - Boeddinghaus, Jasper

AU - Twerenbold, Raphael

AU - Puelacher, Christian

AU - Wussler, Desiree

AU - Strebel, Ivo

AU - Keller, Dagmar I

AU - Poepping, Imke

AU - Kühne, Michael

AU - Mueller, Christian

AU - Reichlin, Tobias

AU - Giménez, Maria Rubini

AU - Walter, Joan

AU - Kozhuharov, Nikola

AU - Shrestha, Samyut

AU - Mueller, Deborah

AU - Sazgary, Lorraine

AU - Morawiec, Beata

AU - Muzyk, Piotr

AU - Nowalany-Kozielska, Ewa

AU - Freese, Michael

AU - Stelzig, Claudia

AU - Meissner, Kathrin

AU - Kulangara, Caroline

AU - Hartmann, Beate

AU - Ferel, Ina

AU - Sabti, Zaid

AU - Greenslade, Jaimi

AU - Hawkins, Tracey

AU - Rentsch, Katharina

AU - von Eckardstein, Arnold

AU - Buser, Andreas

AU - Kloos, Wanda

AU - Lohrmann, Jens

AU - Osswald, Stefan

AU - BASEL IX Investigators

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/10/15

Y1 - 2018/10/15

N2 - BACKGROUND: Various scores have been derived for the assessment of syncope patients in the emergency department (ED) but stay inconsistently validated. We aim to compare their performance to the one of a common, easy-to-use CHADS2 score.METHODS: We prospectively enrolled patients ≥ 40 years old presenting with syncope to the ED in a multicenter study. Early clinical judgment (ECJ) of the treating ED-physician regarding the probability of cardiac syncope was quantified. Two independent physicians adjudicated the final diagnosis after 1-year follow-up. Major cardiovascular events (MACE) and death were recorded during 2 years of follow-up. Nine scores were compared by their area under the receiver-operator characteristics curve (AUC) for death, MACE or the diagnosis of cardiac syncope.RESULTS: 1490 patients were available for score validation. The CHADS2-score presented a higher or equally high accuracy for death in the long- and short-term follow-up than other syncope-specific risk scores. This score also performed well for the prediction of MACE in the long- and short-term evaluation and stratified patients with accuracy comparative to OESIL, one of the best performing syncope-specific risk score. All scores performed poorly for diagnosing cardiac syncope when compared to the ECJ.CONCLUSIONS: The CHADS2-score performed comparably to more complicated syncope-specific risk scores in the prediction of death and MACE in ED syncope patients. While better tools incorporating biochemical and electrocardiographic markers are needed, this study suggests that the CHADS2-score is currently a good option to stratify risk in syncope patients in the ED.TRIAL REGISTRATION: NCT01548352.

AB - BACKGROUND: Various scores have been derived for the assessment of syncope patients in the emergency department (ED) but stay inconsistently validated. We aim to compare their performance to the one of a common, easy-to-use CHADS2 score.METHODS: We prospectively enrolled patients ≥ 40 years old presenting with syncope to the ED in a multicenter study. Early clinical judgment (ECJ) of the treating ED-physician regarding the probability of cardiac syncope was quantified. Two independent physicians adjudicated the final diagnosis after 1-year follow-up. Major cardiovascular events (MACE) and death were recorded during 2 years of follow-up. Nine scores were compared by their area under the receiver-operator characteristics curve (AUC) for death, MACE or the diagnosis of cardiac syncope.RESULTS: 1490 patients were available for score validation. The CHADS2-score presented a higher or equally high accuracy for death in the long- and short-term follow-up than other syncope-specific risk scores. This score also performed well for the prediction of MACE in the long- and short-term evaluation and stratified patients with accuracy comparative to OESIL, one of the best performing syncope-specific risk score. All scores performed poorly for diagnosing cardiac syncope when compared to the ECJ.CONCLUSIONS: The CHADS2-score performed comparably to more complicated syncope-specific risk scores in the prediction of death and MACE in ED syncope patients. While better tools incorporating biochemical and electrocardiographic markers are needed, this study suggests that the CHADS2-score is currently a good option to stratify risk in syncope patients in the ED.TRIAL REGISTRATION: NCT01548352.

KW - Aged

KW - Aged, 80 and over

KW - Electrocardiography/methods

KW - Emergency Service, Hospital/standards

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Syncope/diagnosis

U2 - 10.1016/j.ijcard.2018.06.088

DO - 10.1016/j.ijcard.2018.06.088

M3 - SCORING: Journal article

C2 - 30224031

VL - 269

SP - 114

EP - 121

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

ER -