Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010, 154(2):169-173 | DOI: 10.5507/bp.2010.026

THE EGSYS AND OESIL RISK SCORES FOR CLASSIFICATION OF CARDIAC ETIOLOGY OF SYNCOPE: COMPARISON, REVALUATION, AND CLINICAL IMPLICATIONS

Jiri Plasek^a, Vlastimil Doupal^b, Jana Fürstova^c, Arnost Martinek^a

^a Department of Internal Medicine, University Hospital and Faculty of Health Studies, University of Ostrava, Czech Republic

^b Department of Cardiology, University Hospital and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic

^c Institute of Computer Science, Academy of Sciences of the Czech Republic, Prague, Czech Republic

Aims: EGSYS-U, EGSYS-M, and OESIL risk scores for syncope evaluation are introduced, evaluated retrospectively, and their ability to classify cardiac syncopes is compared. The specificity and sensitivity of the scores were analyzed. Guidelines for the practical application of the scoring systems are provided to reduce unnecessary hospital admissions.

Methods: Retrospectively, 153 patients with syncope admitted to the Faculty Hospital in Ostrava in the year 2008 were enrolled for scoring with the EGSYS and OESIL risk scores. The computed scores were assessed with respect to the diagnosed etiology of the syncope.

Results: For each score system, the hypothesis that there is no difference in the score between the cardiac and the non-cardiac group was rejected (all p-values below 0.0001). Strong correlation between the three score systems was shown (Spearman correlation coefficient: r = 0.71 p < 0.0001 for EGSYS-U and OESIL, r = 0.88 p < 0.0001 for EGSYS-U and EGSYS-M, r = 0.60 p < 0.0001 for EGSYS-M and OESIL). Sensitivity and specificity of the scores were computed and compared.

Conclusions: All three score systems were found capable of classifying cardiac syncopes, reducing unnecessary hospital admissions and improving syncope risk evaluation. EGSYS-U was recommended for emergency syncope management because it was found to have both high sensitivity and high specificity.

Keywords: Syncope, Cardiac Syncope, EGSYS, OESIL, Emergency Department, Decision-Making, Syncope Management Unit

Received: August 14, 2009; Accepted: March 17, 2010; Published: June 1, 2010  Show citation