目的:老年人晕厥的治疗给医疗系统带来了负担。我们使用了五种危险分层工具来预测老年晕厥患者的短期不良结局。
方法:这是一项对城市学术医院急诊科晕厥患者(年龄≥60岁)的回顾性分析。数据使用急诊科晕厥风险分层(ROSE)进行评估,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。灵敏度,特异性,准确度,阳性和阴性预测值(NPV),计算每种工具的阳性和阴性似然比,并比较1个月内的不良事件.
结果:总计,分析了221例患者(平均年龄75.6岁)。59例患者(26.7%)在1个月内发生不良事件。对于玫瑰,SFSR,FAINT,CSRS和BSC工具,敏感性为81.3%,76.3%,93.2%,71.2%,94.9%,特异性为88.3%,87.7%,56.8%,71.6%,和67.3%,NPV为92.9%,91.0%,95.8%,87.2%,和97.3%,分别。
结论:五种评估工具可用于医生筛查老年晕厥患者的短期不良事件风险,根据病人的实际情况。
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.
CONCLUSIONS: 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.