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 Risk Score ≤ −2: very low risk of a serious adverse event within 30 days.
→ Discharge is usually appropriate if there is no other concern. Safety-net advice; driving advice per the local licensing authority.
Canadian Syncope Risk Score −1 to 0: low risk.
→ Discharge with safety-net advice is usually appropriate; consider outpatient follow-up.
Canadian Syncope Risk Score 1–3: medium risk.
→ Consider ED observation with cardiac monitoring and early specialist follow-up; decide on admission with senior review.
Canadian Syncope Risk Score 4–5: high risk.
→ Admit for cardiac monitoring and cardiology review. Echocardiography if not already done.
Canadian Syncope Risk Score ≥ 6: very high risk of arrhythmia, structural heart disease or death within 30 days.
→ Admit to a monitored bed with urgent cardiology input. Do not discharge until the cause is 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.
- Thiruganasambandamoorthy V, et al. Multicenter emergency department validation of the Canadian Syncope Risk Score. JAMA Intern Med. 2020;180(5):737–744.
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.