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Relative utility of serum troponin and the OESIL score in syncope
Author(s) -
Hing Rosslyn,
Harris Roger
Publication year - 2005
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6731.2005.00678.x
Subject(s) - medicine , syncope (phonology) , troponin , confidence interval , cardiology , receiver operating characteristic , troponin t , myocardial infarction
Objective: To investigate the utility of both a random troponin T level taken greater than 4 h after a syncopal event and the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score in predicting outcome post syncope. Methods: We prospectively enrolled 113 adult patients who presented to our ED after a syncopal event. Each patient had a troponin T level taken at least 4 h after the event. The relevant history of the syncope, background medical history and ECG were collected at presentation. Patients were followed up via telephone after 3–6 months and medical records were also examined. The OESIL risk score was calculated for each patient and the predictive value of both the troponin T and OESIL score were analysed for their utility post syncope. Results: Data were analysed for 100 patients. Twenty percent were believed to have a cardiac cause for their syncope. An elevated troponin T level was found to be highly specific (0.99, 95% confidence interval [CI] 0.96–1.0) for adverse cardiac outcome, but with a very low sensitivity (0.13, 95% CI 0–0.3). The OESIL risk score was found to be predictive of an adverse cardiac outcome (receiver–operating characteristic [ROC] 0.73, 95% CI 0.63–0.84) and return to normal function (ROC 0.74, 95% CI 0.63–0.86). Conclusions: A normal serum troponin T has a poor negative predictive value for adverse cardiac outcomes following syncope. A simple risk stratification system, such as the OESIL score, can predict those patients most at risk after a syncopal episode.