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Evidence-Based Medicine 2006;11:186; doi:10.1136/ebm.11.6.186
Copyright © 2006 by the BMJ Publishing Group Ltd.
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Clinical prediction guide

The San Francisco Syncope Rule was useful for stratifying risk in emergency department patients with syncope

Quinn J, McDermott D, Stiell I, et al. Prospective validation of the San Francisco Syncope Rule to predict patients with serious outcomes. Ann Emerg Med 2006;47:448–54.[CrossRef][Medline]

Q In patients presenting at the emergency department (ED) with syncope, how well does the San Francisco Syncope Rule predict whether patients will develop a serious short term outcome not identified at the initial evaluation?

Clinical impact ratings GP/FP/Primary care ******{star} IM/Ambulatory care ******* Cardiology ******{star}

Key Words: clinical protocols • emergency medicine • syncope

The first 150 words of the full text of this article appear below.

METHODS
Formula Design: prospective validation of a previously derived prediction rule.

Formula Setting: a university teaching hospital in San Francisco, California, USA.

Formula Patients: 760 patients 6–99 years of age (mean age 61 y, 54% women) attending the ED (791 visits) for syncope, defined as "transient loss of consciousness with return to baseline neurologic function," or near syncope. Patients with loss of consciousness related to trauma, alcohol, drug use, or seizure were excluded. 54 patients with a serious outcome identified at the initial ED visit and 24 visits without the rule prospectively completed were omitted, leaving 713 visits in the analysis.

Formula Description of prediction guide: the patient was considered to be at high risk of a serious outcome if any one of the 5 components of the rule was present: (1) systolic blood pressure <90 mm Hg, (2) patient complaint of shortness of breath, (3) history of congestive heart failure, (4) haematocrit <30%, or . . . [Full text of this article]

Eddy S Lang, MDCM

SMBD Jewish General Hospital, McGill University,
Montreal, Quebec, Canada






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