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Background <p>Syncope is a&#xa0;common and clinically relevant condition in the emergency department. Accurate risk stratification is essential to distinguish between benign and serious causes, guiding appropriate outpatient or inpatient management. This is crucial for preventing complications and ensuring cost-effective care.</p> Objective <p>This study evaluates the applicability of the 2018 ESC guidelines (European Society of Cardiology) in clinical practice.</p> Methods <p>A&#xa0;retrospective analysis was conducted at a&#xa0;tertiary care emergency department. Data from all patients who presented with syncope in 2022 were included.</p> Results <p>A&#xa0;total of 492 patients were analyzed, including 327 (62.8%) inpatients who underwent full evaluation. High-risk criteria were significantly more frequent among inpatients, while low-risk syncope was more common in the outpatient group. The high-risk criteria of the ESC guidelines demonstrated a&#xa0;sensitivity of 90.8% for the detection of dangerous syncope. In addition, recurrent syncope within the last 12&#xa0;months was associated with an increased risk of dangerous syncope.</p> Conclusion <p>The ESC guidelines demonstrated a&#xa0;sensitivity of over 90%, establishing them as a&#xa0;reliable tool for risk stratification in patients with syncope. Recurrent syncope may represent an additional high-risk criterion that should be further investigated in future prospective studies.</p>

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Synkopendiagnostik im Notfallzentrum – Stellenwert der ESC-Leitlinien

  • 期刊论文

  • 发表日期：

    2025年10月15日

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  • H. Epping,
  • M. Müller-Schilling,
  • G. Dirrigl,
  • F. Rockmann,
  • T. Brünnler

摘要

Background

Syncope is a common and clinically relevant condition in the emergency department. Accurate risk stratification is essential to distinguish between benign and serious causes, guiding appropriate outpatient or inpatient management. This is crucial for preventing complications and ensuring cost-effective care.

Objective

This study evaluates the applicability of the 2018 ESC guidelines (European Society of Cardiology) in clinical practice.

Methods

A retrospective analysis was conducted at a tertiary care emergency department. Data from all patients who presented with syncope in 2022 were included.

Results

A total of 492 patients were analyzed, including 327 (62.8%) inpatients who underwent full evaluation. High-risk criteria were significantly more frequent among inpatients, while low-risk syncope was more common in the outpatient group. The high-risk criteria of the ESC guidelines demonstrated a sensitivity of 90.8% for the detection of dangerous syncope. In addition, recurrent syncope within the last 12 months was associated with an increased risk of dangerous syncope.

Conclusion

The ESC guidelines demonstrated a sensitivity of over 90%, establishing them as a reliable tool for risk stratification in patients with syncope. Recurrent syncope may represent an additional high-risk criterion that should be further investigated in future prospective studies.