The performance of the Evaluation of Guidelines in Syncope Study score in the diagnostic approach to syncope in emergency department

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Published Mar 2, 2025
https://doi.org/10.62438/tunismed.v103i3.5417
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Vol. 103 No. 3 (2025): Tunis Med Mar 2025

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Hanen Ghazali
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Hela Chabbah
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Ines Chermiti
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Rym Hamed
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Héla Ben Turkia
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Syrine Keskes
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Raja Fadhel
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Sami Souissi
Yasminet Regional Hospital, Emergency department, Ben Arous,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia

Abstract

Background: Management of syncope in the emergency department (ED) is not yet well codified. Several scores have been developed to facilitate diagnosis and management. According to the European Society of Cardiology, an EGSYS (Evaluation of Guidelines in Syncope Study) score ≥3 predicts cardiac origin.


Objective: Evaluate the performance of the EGSYS score in the diagnosis of cardiac syncope in ED.


Methods: We conducted a prospective study (2011-2021). Inclusion of patients who consult for syncope with calculation of the EGSYS score. Diagnosis of cardiac syncope was based on the results of the cardiological investigation. Patients were divided into two groups: SC+ group with cardiac syncope and SC- group with another etiology.


Results: Inclusion of 526 patients. Mean age =49± 20 years. Gender ratio=1.48. Two hundred and thirty-six patients (45%) had a cardiac syncope. Comparison between the two groups (SC+ versus (vs. SC-) showed the following results: mean age (58 ±19 vs. 42 ±18 years), history of heart disease: 34 (14.5%) vs. 13 (4.5%), rhythm disorders 22(9.4%) vs. 4(1.4%), bradycardia: 40 (17%) vs. 17 (5.8%),  atrioventricular block: 26 (11.1%) vs. 8 (2.7%), bundle branch block: 45 (19.1%) vs. 17 (5.8%), High risk criteria: 138 (58.7%) vs. 75 (25.8%). Diagnostic performance of the EGSYS score was satisfactory with AUC=0.769, CI95% [0.73 – 0.81], p < 0.001. The threshold value was 3. Sensitivity, specificity, positive predictive value and negative predictive value were 79, 80, 76 and 83% respectively. Likelihood Ratio: Positive LR=4.04, negative LR=0.26.


Conclusion: The EGSYS score showed   ..(abstract truncated at 250 words)

Keywords:

Syncope, Emergency, Diagnosis, Prognosis, clinical score, EGSYS score

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