Improving Management of Emergency Department Patients With Undifferentiated Syncope: Prospective Validation of the Canadian Syncope Risk Score

Launched by KAISER PERMANENTE · Sep 8, 2022

Keywords

ClinConnect Summary

This study is an observational, prospective cohort designed to test how well the Canadian Syncope Risk Score (CSRS) can predict serious health problems in the next 30 days after a fainting spell. It uses data already collected in the Kaiser Permanente Northern California system and does not test a new drug or device. The goal is to see how accurately the CSRS can identify people who are at higher risk for serious events, such as heart rhythm problems or other complications, after an emergency department visit for syncope or near-fainting.

Who can participate: Kaiser Permanente members aged 16 or older who come to an emergency department with recent syncope or presyncope (within 24 hours) and for whom the initial ED assessment did not reveal a definite serious cause. People are not eligible if they are under 16, not Kaiser members, had a clearly witnessed seizure, a very long loss of consciousness (more than 5 minutes), trauma-related hospitalization, or significant communication barriers. If you’re eligible, you’ll be identified through the ED’s electronic health record tools. The study aims to enroll about 4,000 participants across several Kaiser EDs in California, and no individual results will change your care as part of the study. The main outcome they’ll track is whether a patient experiences a serious event within 30 days, including heart rhythm problems or non-heart-related issues like heart attack or pulmonary embolism. Data sharing for outside researchers is not planned.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age ≥16y
• • Member of Kaiser Permanente Northern California (KPNC) health plan
• • Presentation to the ED with an ED diagnosis of recent syncope or presyncope (\<24h) without a serious etiology identified during the initial ED diagnostic assessment, that is, patients with unexplained syncope.
• • Subjects who meet criteria will be identified electronically within the CDS tool in the electronic health record.
• Exclusion Criteria:
• • Age \<16 years old
• • Non-members of KPNC
• • Patients with obvious witnessed seizure, prolonged loss of consciousness (\>5 minutes), post-traumatic loss of consciousness, and new mental status changes
• • Patients requiring hospitalization for traumatic injuries (e.g., syncope leading to motorized vehicle collision), because their outcomes may be related to trauma rather than syncope
• • Patients with impaired communication capacity, e.g., intoxication, language barriers, and dementia.