Canadian Syncope Risk Score
Predicts risk of serious adverse events (arrhythmia, death, MI, structural heart disease) within 30 days of syncope presentation to ED. Guides admission vs safe discharge.
Score interpretation
Canadian Syncope Score ≤ 0: Very low risk of serious adverse event within 30 days.
→ Safe for discharge. Vasovagal education. Driving restrictions per local DVLA/transport authority guidelines. Return if recurrence or new symptoms.
Canadian Syncope Score 1–3: Low risk.
→ Consider discharge with rapid outpatient follow-up (Holter, echo if not done). ED observation optional. Driving advice.
Canadian Syncope Score 4–5: Medium risk.
→ Admit for cardiac monitoring (telemetry). Cardiology review. Echo if not done. 24–48h observation.
Canadian Syncope Score ≥ 6: High risk of serious arrhythmia, MI, or death within 30 days.
→ Admit to monitored bed/cardiology. Urgent echo, Holter. Electrophysiology study if arrhythmia suspected. Do not discharge until cause identified and treated.
Interpretation bands for the Canadian Syncope. Apply clinical judgement and local guidance.
References
- Thiruganasambandamoorthy V, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ. 2016;188(12):E289–E298.
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.