응급의료센터 실신 위험도평가 연구의 표준화된 보고지침을 적용하여 시행한 San Francisco Syncope Rule의 외부적 타당화 연구 (External Validation Study of San Francisco Syncope Rule Based on Standardized Reporting Guidelines for Emergency Department Syncope Risk Stratification Research)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 25권 / 1호 / 23 ~ 34페이지
· 저자명 : 예성열, 권오영, 이종석, 홍훈표, 고영관, 최한성

초록

Purpose: We validated the performance of the SanFrancisco Syncope Rule (SFSR) for accurate identificationof Korean emergency department (ED) syncope patientswho will experience a short term serious outcome.
Methods: This retrospective study included patients over16 years old who fulfilled the inclusion criteria according tothe definition of syncope and visited the ED from January2010 to June 2013. The authors excluded patients withalcohol or illicit drugs use seizure, stroke or transientischemic attack, head trauma followed by loss of consciousness,or hypoglycemia. The patients were dividedinto two groups according to the SFSR for the purpose ofperforming a comparative analysis. The authors calculatedsensitivity, specificity, positive predictive value, and negativepredictive value of SFSR and analyzed other variables,except five predictor variables of SFSR.
Results: Of 1,235 visits screened, 409 were included. Theaverage age of enrolled patients was 55.2±20.1 and malepopulation accounted for 45.0%(n=184). A total of 93(27.7%) patients experienced serious outcomes; 41 of 287(14.3%) patients with a serious outcome were not identifiedas high risk according to the rule. The rule performed with asensitivity of 55.9%, specificity of 77.8%, positive predictivevalue of 42.6%, and negative predictive value of 85.7%.
Conclusion: In this retrospective validation study based onthe standardized reporting guidelines for ED syncope riskstratification research, the SFSR performed with significantlylower sensitivity than previously reported. The resultssuggest that application of the original rule has limited generalizabilityand conduct of future studies will be needed inorder to refine the SFSR.

영어초록

Purpose: We validated the performance of the SanFrancisco Syncope Rule (SFSR) for accurate identificationof Korean emergency department (ED) syncope patientswho will experience a short term serious outcome.
Methods: This retrospective study included patients over16 years old who fulfilled the inclusion criteria according tothe definition of syncope and visited the ED from January2010 to June 2013. The authors excluded patients withalcohol or illicit drugs use seizure, stroke or transientischemic attack, head trauma followed by loss of consciousness,or hypoglycemia. The patients were dividedinto two groups according to the SFSR for the purpose ofperforming a comparative analysis. The authors calculatedsensitivity, specificity, positive predictive value, and negativepredictive value of SFSR and analyzed other variables,except five predictor variables of SFSR.
Results: Of 1,235 visits screened, 409 were included. Theaverage age of enrolled patients was 55.2±20.1 and malepopulation accounted for 45.0%(n=184). A total of 93(27.7%) patients experienced serious outcomes; 41 of 287(14.3%) patients with a serious outcome were not identifiedas high risk according to the rule. The rule performed with asensitivity of 55.9%, specificity of 77.8%, positive predictivevalue of 42.6%, and negative predictive value of 85.7%.
Conclusion: In this retrospective validation study based onthe standardized reporting guidelines for ED syncope riskstratification research, the SFSR performed with significantlylower sensitivity than previously reported. The resultssuggest that application of the original rule has limited generalizabilityand conduct of future studies will be needed inorder to refine the SFSR.

참고자료

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