Predictive Factors of Serious Etiology in Patients with Syncope

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 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 or =47 years, and admission via an out-patient department or transfer from an outside hospital.