Resumen

MENDEZ, Arnold; ROJAS, Ingrid Tatiana; AMARIS, Óscar Ernesto  y  MORA, Guillermo. Prognostic performance of clinical decision rules in syncope A pilot study. Acta Med Colomb [online]. 2015, vol.40, n.1, pp.36-44. ISSN 0120-2448.

Objective: to develop a feasibility pilot study comparing the prognostic performance of clinical decision rules in patients with syncope. Secondary objective: To assess the prognostic performance of OESIL (Osservatorio sulla Epidemiologico Sincope nel Lazio) decision rules, EGSYS (European Guidelines in Syncope Study), SFSR (San Francisco Syncope Rule) and its application to the Ottawa Electrocardiographic Criteria (SFSR + Ottawa) in predicting all-cause mortality and cardiovascular and non-cardiovascular outcomes longer than seven and 30 days. Methods: an observational, analytical, prospective, longitudinal, non-interventional study with convenience sampling. Patients >18 years of age admitted to the emergency room less than or equal to 48 hours after onset of syncope were included. Rules were compared by using ROC curves and sensitivity, specificity, PPV and NPV for mortality and major outcomes to seven and 30 days. Results: 44 patients were included over a period of seven months. 100% were hospitalized. ROC analysis showed an AUC for SFSR + Ottawa for mortality and / or major outcomes to 7 days of 0.76 (95% CI 0.49 to 0.82) and 30 days 0.76 (95% CI 0.49-0.82) with sensitivity of 86 and 84% and specificity of 45 and 47% for seven and 30 days respectively. Conclusions: it is feasible to conduct a comparison study of prognostic performance of clinical decision rules of syncope in Colombia. The comparison realized suggests a better performance of SFSR if applied with electrocardiographic criteria of Ottawa (SFSR + Ottawa) for predicting outcomes in the short term. (Acta Med Colomb 2015; 40: 36-44).

Palabras clave : syncope; clinical prediction rules.

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