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Validation of EGSYS Score in Prediction of Cardiogenic Syncope.

Kariman H, Harati S, Safari S, Baratloo A, Pishgahi M - Emerg Med Int (2015)

Bottom Line: Sensitivity and specificity were 86.08% (95% CI: 78.09-91.59) and 68.29% (95% CI: 56.97-77.86) for EGSYS-U and 91.30% (95% CI: 84.20-95.52) and 57.32% (95% CI: 45.92-68.02) for EGSYS-M, respectively.Conclusion.It seems that using this model in daily practice can help physicians select at risk patients and properly triage them.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran 19899 34148, Iran.

ABSTRACT
Introduction. Evaluation of Guidelines in Syncope Study (EGSYS) is designed to differentiate between cardiac and noncardiac causes of syncope. The present study aimed to evaluate the accuracy of this predictive model. Methods. In this prospective cross-sectional study, screening performance characteristics of EGSYS-U (univariate) and EGSYS-M (multivariate) in prediction of cardiac syncope were calculated for syncope patients who were referred to the emergency department (ED). Results. 198 patients with mean age of 59.26 ± 19.5 years were evaluated (62.3% male). 115 (58.4%) patients were diagnosed with cardiac syncope. Area under the ROC curve was 0.818 (95% CI: 0.75-0.87) for EGSYS-U and 0.805 (CI 95%: 0.74-0.86) for EGSYS-M (p = 0.53). Best cut-off point for both models was ≥3. Sensitivity and specificity were 86.08% (95% CI: 78.09-91.59) and 68.29% (95% CI: 56.97-77.86) for EGSYS-U and 91.30% (95% CI: 84.20-95.52) and 57.32% (95% CI: 45.92-68.02) for EGSYS-M, respectively. Conclusion. The results of this study demonstrated the acceptable accuracy of EGSYS score in predicting cardiogenic causes of syncope at the ≥3 cut-off point. It seems that using this model in daily practice can help physicians select at risk patients and properly triage them.

No MeSH data available.


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Comparative receiver operative characteristic (ROC) curve of univariate EGSYS (EGSYS-U) and multivariate EGSYS (EGSYS-M).
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fig1: Comparative receiver operative characteristic (ROC) curve of univariate EGSYS (EGSYS-U) and multivariate EGSYS (EGSYS-M).

Mentions: 206 patients were evaluated; however, 8 cases with mean age of 50.0 ± 22.74 (75.0% male) were excluded due to unknown origin of syncope. No cases of miss or death happened during the patients' follow-up period. The EGSYS-M score of all excluded patients were ≤2. Finally, 198 patients with mean age of 59.26 ± 19.5 years (range: 13–98) were enrolled in the study (62.3% male). Table 1 shows baseline characteristics of the participants. Frequency of EGSYS risk factors is shown in Table 2. 115 (58.4%) patients were diagnosed with cardiac and 83 (41.6%) with noncardiac origin. The comparison of EGSYS risk factors between cardiac and noncardiac syncope can be found in Table 3. Mean EGSYS-U and EGSYS-M scores were 3.57 ± 3.05 (minimum −4 and maximum 10) and 3.73 ± 2.68 (minimum −2 and maximum 10), respectively. Mean EGSYS-M and EGSYS-U scores for cardiac and noncardiac causes were 4.9 ± 2.1 and 2.11 ± 2.4 (p < 0.001) and 5 ± 2.5 and 1.6 ± 2.6 (p < 0.001), respectively. Figure 1 shows the comparative ROC curve of the 2 mentioned models. Area under the ROC curve was 0.818 (95% CI: 0.75–0.87) for EGSYS-U and 0.805 (CI 95%: 0.74–0.86) for EGSYS-M (p = 0.53). Best cut-off point for both models was estimated to be ≥3. Table 4 summarizes screening performance characteristics of the 2 mentioned models. At ≥3 cut-off point, sensitivity and specificity were 86.08% (95% CI: 78.09–91.59) and 68.29% (95% CI: 56.97–77.86) for EGSYS-U and 91.30% (95% CI: 84.20–95.52) and 57.32% (95% CI: 45.92–68.02) for EGSYS-M, respectively.


Validation of EGSYS Score in Prediction of Cardiogenic Syncope.

Kariman H, Harati S, Safari S, Baratloo A, Pishgahi M - Emerg Med Int (2015)

Comparative receiver operative characteristic (ROC) curve of univariate EGSYS (EGSYS-U) and multivariate EGSYS (EGSYS-M).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4663288&req=5

fig1: Comparative receiver operative characteristic (ROC) curve of univariate EGSYS (EGSYS-U) and multivariate EGSYS (EGSYS-M).
Mentions: 206 patients were evaluated; however, 8 cases with mean age of 50.0 ± 22.74 (75.0% male) were excluded due to unknown origin of syncope. No cases of miss or death happened during the patients' follow-up period. The EGSYS-M score of all excluded patients were ≤2. Finally, 198 patients with mean age of 59.26 ± 19.5 years (range: 13–98) were enrolled in the study (62.3% male). Table 1 shows baseline characteristics of the participants. Frequency of EGSYS risk factors is shown in Table 2. 115 (58.4%) patients were diagnosed with cardiac and 83 (41.6%) with noncardiac origin. The comparison of EGSYS risk factors between cardiac and noncardiac syncope can be found in Table 3. Mean EGSYS-U and EGSYS-M scores were 3.57 ± 3.05 (minimum −4 and maximum 10) and 3.73 ± 2.68 (minimum −2 and maximum 10), respectively. Mean EGSYS-M and EGSYS-U scores for cardiac and noncardiac causes were 4.9 ± 2.1 and 2.11 ± 2.4 (p < 0.001) and 5 ± 2.5 and 1.6 ± 2.6 (p < 0.001), respectively. Figure 1 shows the comparative ROC curve of the 2 mentioned models. Area under the ROC curve was 0.818 (95% CI: 0.75–0.87) for EGSYS-U and 0.805 (CI 95%: 0.74–0.86) for EGSYS-M (p = 0.53). Best cut-off point for both models was estimated to be ≥3. Table 4 summarizes screening performance characteristics of the 2 mentioned models. At ≥3 cut-off point, sensitivity and specificity were 86.08% (95% CI: 78.09–91.59) and 68.29% (95% CI: 56.97–77.86) for EGSYS-U and 91.30% (95% CI: 84.20–95.52) and 57.32% (95% CI: 45.92–68.02) for EGSYS-M, respectively.

Bottom Line: Sensitivity and specificity were 86.08% (95% CI: 78.09-91.59) and 68.29% (95% CI: 56.97-77.86) for EGSYS-U and 91.30% (95% CI: 84.20-95.52) and 57.32% (95% CI: 45.92-68.02) for EGSYS-M, respectively.Conclusion.It seems that using this model in daily practice can help physicians select at risk patients and properly triage them.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran 19899 34148, Iran.

ABSTRACT
Introduction. Evaluation of Guidelines in Syncope Study (EGSYS) is designed to differentiate between cardiac and noncardiac causes of syncope. The present study aimed to evaluate the accuracy of this predictive model. Methods. In this prospective cross-sectional study, screening performance characteristics of EGSYS-U (univariate) and EGSYS-M (multivariate) in prediction of cardiac syncope were calculated for syncope patients who were referred to the emergency department (ED). Results. 198 patients with mean age of 59.26 ± 19.5 years were evaluated (62.3% male). 115 (58.4%) patients were diagnosed with cardiac syncope. Area under the ROC curve was 0.818 (95% CI: 0.75-0.87) for EGSYS-U and 0.805 (CI 95%: 0.74-0.86) for EGSYS-M (p = 0.53). Best cut-off point for both models was ≥3. Sensitivity and specificity were 86.08% (95% CI: 78.09-91.59) and 68.29% (95% CI: 56.97-77.86) for EGSYS-U and 91.30% (95% CI: 84.20-95.52) and 57.32% (95% CI: 45.92-68.02) for EGSYS-M, respectively. Conclusion. The results of this study demonstrated the acceptable accuracy of EGSYS score in predicting cardiogenic causes of syncope at the ≥3 cut-off point. It seems that using this model in daily practice can help physicians select at risk patients and properly triage them.

No MeSH data available.


Related in: MedlinePlus