Comparación de cuatro escalas de riesgo en pacientes que consultaron por síncope al servicio de urgencias

Abstract

Introduction: Syncope is a common complaint in the emergency department, defining the proper studies and destination of these patients is still a matter of debate. There have been various tools designed to help establish which of these patients are at risk of having an adverse outcome, and therefore require admission. In this study ther are compared the operative characteristics of 4 scales for the decisión to hospitalize patients with syncope that they consult to a emergency department of an III/IV level hospital Methods: Analytic cross study, in which 4 risk scales were applied to patients consulting with a chief complaint of syncope in the emergency department, and were admitted during a 6 month period in a single institution. The results were evaluated with Epidat 3.1 to calculate sensitivity and specificity, Youden index. Results: 91 patients were included in total. The sensibility of the scales San Francisco, OESIL, EGSYS and the institutional one for the requirement of hospitalization was 79 %, 87 %. 63 % and 95 % respectively and the specificity was 52 %, 40 %, 64 % and 14 %. THE risk of mortality was not detected adequately by the scale of San Francisco. Conclusions: None of the scales applied to the hospitalized patients who consulted for sìncope to urgencies overcame the clinical judgment to define the hospitalization. Nevertheless, the scale OESIL and the institutional one can help to corroborate the clinical decision to hospitalize in this population.