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, Vol. 269, 15.10.2018, p. 114-121.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -