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Statements

Subject Item
dbr:San_Francisco_Syncope_Rule
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rdfs:label
San Francisco Syncope Rule
rdfs:comment
The San Francisco Syncope Rule (SFSR) is a rule for evaluating the risk of adverse outcomes in patients presenting with fainting or syncope. The mnemonic for features of the rule is CHESS: • C - History of congestive heart failure • H - Hematocrit < 30% • E - Abnormal ECG • S - Shortness of breath • S - Triage systolic blood pressure < 90
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dbc:Autonomic_nervous_system dbc:Cardiology
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16774644
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1040374972
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dbr:Vasovagal_syncope dbr:Hematocrit dbr:Hemorrhage dbr:Blood_pressure dbc:Autonomic_nervous_system dbr:Pulmonary_embolism dbr:Heart_failure dbr:Emergency_department dbr:Subarachnoid_hemorrhage dbr:Stroke dbr:Fainting dbc:Cardiology dbr:Electrocardiogram dbr:Cardiac_arrhythmia dbr:Myocardial_infarction
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dbo:abstract
The San Francisco Syncope Rule (SFSR) is a rule for evaluating the risk of adverse outcomes in patients presenting with fainting or syncope. The mnemonic for features of the rule is CHESS: • C - History of congestive heart failure • H - Hematocrit < 30% • E - Abnormal ECG • S - Shortness of breath • S - Triage systolic blood pressure < 90 A patient with any of the above measures is considered at high risk for a serious outcome such as death, myocardial infarction, arrhythmia, pulmonary embolism, stroke, subarachnoid hemorrhage, significant hemorrhage, or any condition causing a return Emergency Department visit and hospitalization for a related event. SFSR was retrospectively found to have 98% sensitivity and specificity of 56% for serious causes of syncope. However, external prospective validation of the criteria found sensitivity to be 74%, substantially lower than the initial study. This means that in patients with none of the above criteria, potentially serious causes of syncope were missed in over a quarter of patients. Syncope accounts for 1-2% emergency department visits. Half are hospitalized and of these, 50% have unclear diagnosis and 85% will be simply monitored.
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