Comparison of Canadian and San Francisco syncope rules in patients admitted to emergency department with syncope

Abstract

Aim: Syncope is the totality of symptoms in which consciousness is temporarily lost and postural tonus cannot be maintained, which resolves spontaneously and completely without any medical intervention. Although syncope has an important place among the reasons for admission to the emergency department, the diagnostic approach and what should be done in terms of discharge have not yet been fully systematized. In this study, a comparison was made according to age, gender, known diseases, and San Francisco and Canadian syncope rules. Methodology: This is a single-center, retrospective cohort study. During the study period, the vital parameters, ECG, blood tests, and physical examination findings of the patients who presented to the emergency department with the complaint of fainting were evaluated. The number of points scored by the San Francisco and Canadian syncope criteria was determined for each patient. It was stated which of the discharge, hospitalization in the ward, intensive care unit, and ex results each patient ended with. Each patient was investigated after 30 days, and it was investigated whether there were any of the negative results we wrote above within 30 days. At the end of all these, the San Francisco and Canadian syncope criteria were compared with the analysis method. Results: The study included 449 patients, of whom 52.1% were male and 47.9% were female, with a serious outcome rate of 10%, a readmission rate of 11.4%, and a mortality rate of 1.1%. Conclusion: In this study, it was found that the rate of no adverse events was significantly higher when the San Francisco Syncope Rule were negative; the San Francisco Syncope Criteria and the Canadian Syncope Rule gave similar results in predicting mortality and morbidity; the Canadian Syncope Rule were slightly more effective in predicting morbidity and mortality.