J Korean Soc Emerg Med.  2007 Dec;18(6):590-597.

Predictive Factors of Serious Etiology in Patients with Syncope

• Sung AJ
• Ryoo HW
• Seo KS
• Park JB
• Chung JM
• Lee WK
• Cho YK
• Seo JS
• Je DW
• Kim CH

Abstract

PURPOSE: To stratify the risk of syncope by analyzing related risk factors of patients with possibly serious etiology who visit the emergency room with syncope.
METHODS
We studied 201 patients who visited the emergency room of Kyungpook National University Hospital with syncope from January 2004 to December 2006. We defined serious etiology as arrhythmia, angina pectoris, myocardial infarction, septic shock, meningitis, cerebral infarction, subarachnoid hemorrhage, brain tumor, significant hemorrhage, and malfunction of cardiac pacemaker requiring immediate treatment and intervention. We analyzed the relationship between 81 risk factors and serious etiology to stratify the risk for patients with syncope.
RESULTS
The patient group consisted of 105 males and 96 females with an average age of 56.4+/-20.7 years. Fifty-four patients had serious etiology. Among the 81 risk factors, those identified through univariate and multivariate analysis as having high predictive sensitivity and specificity were shortness of breath (odds ratio [OR]: 18.34, 95% confidence interval [CI]: 5.59-60.16); abnormal electrocardiography (OR: 10.29, 95% CI: 1.43-74.33); hematocrit <28.3% (OR: 9.64, 95% CI: 3.47-26.73); age > or =47 years (OR: 6.24, 95% CI: 1.14-34.17); and admission via an out-patient department or by transfer from outside hospital (OR: 4.07, 95% CI: 1.15-14.36).
CONCLUSION
Risk factors correlated with serious etiology for syncope are shortness of breath, abnormal electrocardiography, hematocrit <28.3%, age > or =47 years, and admission via an out-patient department or transfer from an outside hospital.

Keyword

Syncope; Etiology; Risk Factors

MeSH Terms

Angina Pectoris
Arrhythmias, Cardiac
Brain Neoplasms
Cerebral Infarction
Dyspnea
Electrocardiography
Emergency Service, Hospital
Female
Gyeongsangbuk-do
Hematocrit
Hemorrhage
Humans
Male
Meningitis
Multivariate Analysis
Myocardial Infarction
Outpatients
Risk Factors
Sensitivity and Specificity
Shock, Septic
Subarachnoid Hemorrhage
Syncope*