Canadian Syncope Risk Score

Why Use

Syncope is a common, often benign presenting complaint in emergency departments, that sometimes has life-threatening underlying causes. The Canadian Syncope Risk Score identifies patients with syncope who are at higher risk of adverse outcomes. Can potentially avoid unnecessary investigation and/or admission.

When to Use

Patients ≥16 years old presenting ≤24 hours of syncope. Do not use in patients with any of the following: Prolonged (>5 min) LOC. Change in mental status from baseline. Obvious witnessed seizure. Major trauma requiring hospital admission. Intoxication with alcohol or illicit drugs. Language barrier. Head trauma causing LOC.

Formula

Pearls / Pitfalls

Predicts risk of 30-day serious adverse events associated with syncope, defined as any of the following: death, arrhythmia, non-arrhythmic cardiac causes, or non-cardiac causes (see Evidence for full list). In 2020, the CSRS was successfully validated (see Evidence , below).

Advice

Patients at medium or high risk (≥1 point) should undergo further investigation for cardiac and non-cardiac causes of syncope.

More Information

Interpretation: Score Estimated risk of serious adverse event** Risk category -3 0.4% Very low -2 0.7% -1 1.2% Low 0 1.9% 1 3.1% Medium 2 5.1% 3 8.1% 4 12.9% High 5 19.7% 6 28.9% Very high 7 40.3% 8 52.8% 9 65.0% 10 75.5% 11 83.6% **Death, arrhythmia, myocardial infarction, serious structural heart disease, aortic dissection, pulmonary embolism, severe pulmonary hypertension, severe hemorrhage, subarachnoid hemorrhage, or any other serious condition causing syncope and procedural interventions for the treatment of syncope.