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J Korean Soc Emerg Med > Volume 29(2); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(2): 212-222.
일개 병원에서 실신으로 응급실을 내원한 환자에게 적용한 Canadian Syncope Risk Score에 대한 고찰
이경화1, 박용석2* , 최마이클승필2 , 제동욱2 , 김성훈2 , 노우영2 , 박홍인2 , 신수정2 , 이미진3 , 안재윤3 , 이동언3 , 문성배3 , 이숙희4
1차의과학대학교 분당차병원 응급의학과
2차의과학대학교 구미차병원 응급의학과
3경북대학교 의학전문대학원 응급의학교실
4대구가톨릭대학교 의과대학 응급의학교실
A single emergency center study on the Canadian Syncope Risk Score applied to a patients visited with syncope in Korea
Kyung Wha Lee1, Yong Seok Park2* , Michael Sung Pil Choe2 , Dong Wook Je2 , Seong Hun Kim2 , Woo Young Nho2 , Hong In Park2 , Su Jeong Shin2 , Mi Jin Lee3 , Jae Yun Ahn3 , Dong Eun Lee3 , Sungbae Moon3 , Suk Hee Lee4
1Department of Emergency Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
2Department of Emergency Medicine, CHA Gumi Medical Center, CHA University, Gumi, Korea
3Department of Emergency Medicine, School of Medicine, Kyungbook National University, Daegu, Korea
4Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
Correspondence  Yong Seok Park ,Tel: 054-450-9997, Fax: 054-450-9886, Email: jisilpark@naver.com,
Received: June 29, 2017; Revised: July 3, 2017   Accepted: October 16, 2017.  Published online: April 30, 2018.
Syncope is mostly benign, but it can also be caused by a life-threatening situation. In Korea, no studies have investigated application of the Canadian Syncope Risk Score (CSRS) to patients with syncope; therefore, this study was started to evaluate the usefulness of CSRS.
A total of 222 patients who visited the emergency room with syncope for one year from January 2016 to December 2016 were enrolled in this study. Patients were divided into two groups, a serious adverse events (SAE) group and a non-serious adverse events group. The scores of the nine CSRS variables were added and the CSRS was then calculated after the addition.
The CSRS score for patients with SAE ranged from 0 to 8. The CSRS score was 18.6%, 31.7%, 55.6%, and 58.8% for 0, 1, 2, and 3, respectively. In the case of CSRS 0 and 1, 17 patients (81.0%) and 11 patients (84.6%) were non-cardiac. In the case of CSRS 2, 7 were non-cardiac (70.0%). In the case of CSRS 3, 6 cases (60.0%) were cardiogenic and 4 cases (40.0%) were non-cardiogenic. The area under the receiver operating characteristic curve of CSRS to predict SAE was 0.71. Setting the CSRS cutoff value to 0, we found that sensitivity and specificity of predicting SAE was 67.19% and 67.09%, respectively.
CSRS may be difficult to predict for acute intracranial disease or acute hemorrhagic disease requiring transfusion; therefore, it is necessary to supplement it further.
Key words: Syncope; Risk factors; Emergency service; Hospitals
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