Synocope

Score results Validation Comments

Consider admission for Internal: 97% sensitivity, 25 variables in eight categories make it less
one or more variables 62% specificity practical
External: none

Estimated risk of serious Pending Largest prospective study, outcomes

adverse event at 30 days consistent with guidelines, clarifies
abnormal ECG findings, pending
validation to support use of rule

Consider admission for Internal: 92% sensitivity, Mortality at two years was 2% in patients
score of 3 or higher 69% specificity with scores < 3 and 21% for scores ≥ 3
External: 56% sensitivity,
84% specificity

Consider admission for Internal: 100% sensitivity, Positive variables:

one or more variables 22% specificity 0: 0% mortality
External: 95% sensitivity, 1: 0.6% mortality
31% specificity 2: 14% mortality
3: 29% mortality
4: 53% mortality

Consider admission for
one or more variables
Internal: 87% sensitivity, Not useful for predicting outcomes at one
66% specificity year; first study to use a biomarker in risk
One-year outcomes: stratification
72% sensitivity, 71%
specificity
External: none

Consider admission for Internal: 98% sensitivity, First tool for short-term events (seven days);
one or more variables 56% specificity inconsistencies in validation scores, but
External: 87% sensitivity, the most studied decision tool
52% specificity

CVA = cerebrovascular accident; ECG = electrocardiography; ED = emergency department; EGSYS = Evaluation

of Guidelines in Syncope Study; MI = myocardial infarction; OESIL = Osservatorio Epidemiologico sulla Sincope
nel Lazio; PE = pulmonary embolism; ROSE = Risk Stratification of Syncope in the Emergency Department.
*—Abnormal ECG definitions varied with each study.

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