老年人晕厥的五种风险分层工具的应用。
Application of five risk stratification tools for syncope in older adults.
机构信息
Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurocardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
J Int Med Res. 2024 Jan;52(1):3000605231220894. doi: 10.1177/03000605231220894.
OBJECTIVE
Treatment of syncope in older adults places a burden on healthcare systems. We used five risk stratification tools to predict short-term adverse outcomes in older patients with syncope.
METHODS
This was a retrospective analysis of patients with syncope (age ≥60 years) in the emergency department of an urban academic hospital. The data were evaluated using the Risk Stratification of Syncope in the Emergency Department (ROSE), San Francisco Syncope Rule (SFSR), FAINT, Canadian Syncope Risk Score (CSRS), and Boston Syncope Criteria (BSC) tools. Sensitivity, specificity, accuracy, positive and negative predictive value (NPV), and positive and negative likelihood ratios of each tool were calculated and compared for adverse events within 1 month.
RESULTS
In total, 221 patients (average age 75.6 years) were analyzed. Fifty-nine patients (26.7%) had experienced an adverse event within 1 month. For the ROSE, SFSR, FAINT, CSRS and BSC tools, sensitivities were 81.3%, 76.3%, 93.2%, 71.2%, and 94.9%, specificities were 88.3%, 87.7%, 56.8%, 71.6%, and 67.3%, and NPVs were 92.9%, 91.0%, 95.8%, 87.2%, and 97.3%, respectively.
CONCLUSION
The five assessed tools could be useful for physicians in screening older patients with syncope for the risk of short-term adverse events, according to the patient's actual situation.
目的
老年人晕厥的治疗给医疗保健系统带来了负担。我们使用了五种风险分层工具来预测老年晕厥患者的短期不良结局。
方法
这是对城市学术医院急诊科晕厥（年龄≥60 岁）患者的回顾性分析。使用风险分层晕厥在急诊科（ROSE），旧金山晕厥规则（SFSR），FAINT，加拿大晕厥风险评分（CSRS）和波士顿晕厥标准（BSC）工具评估数据。计算并比较了每种工具在 1 个月内不良事件的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）以及阳性和阴性似然比。
结果
共分析了 221 例患者（平均年龄 75.6 岁）。59 例（26.7%）在 1 个月内发生了不良事件。对于 ROSE、SFSR、FAINT、CSRS 和 BSC 工具，敏感性分别为 81.3%、76.3%、93.2%、71.2%和 94.9%，特异性分别为 88.3%、87.7%、56.8%、71.6%和 67.3%，NPV 分别为 92.9%、91.0%、95.8%、87.2%和 97.3%。
结论
根据患者的实际情况，这五种评估工具可用于医生筛查老年晕厥患者短期不良事件的风险。
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