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

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 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 ★★★★★★☆ IM/Ambulatory care ★★★★★★★ Cardiology ★★★★★★☆


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prospective validation of a previously derived prediction rule.

Embedded ImageSetting:

a university teaching hospital in San Francisco, California, USA.

Embedded ImagePatients:

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 …

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  • For correspondence: Dr J Quinn, Stanford University, Palo Alto, CA, USA. quinnj{at}

  • Source of funding: National Institutes of Health.