Utility of Serum S100B Level, SFSR and OESIL Scores in Anticipating Short Term Adverse Events of Discharged Syncope Patients

Abstract

Objective: Our aim is to evaluate S100 beta in serum in addition to clinical syncope decision rules and to determine the utility of this parameter along with OESIL and SFSR for any short term (10 days) adverse events. Material and Methods: This observational prospective cohort study included all consecutive patients older than 18 years who presented to the ED of Marmara University Hospital between June 2005 and January 2007 with the complaint of syncope within the previous 48 hours unless they had exclusion criteria. Two hundred and fifty-four patients were admitted, 80 were enrolled and 62 completed the follow-up. Multivariable logistic regression analysis was used to develop a risk score to predict the probability any adverse event in the short term using parameters of OESIL risk score, SFSR and serum S-100 beta level. Results: Patients with any short term adverse events had a higher pulse rate, lower hematocrit and hemoglobin levels, and higher serum S100B levels on admission. There were no significant differences between the accuracies of OESIL, SFS Rule and S100B level. Absence of prodromal symptoms, abnormal ECG and high serum S100B level were significant contributors of the model of adverse events. OESIL and S100B level were relatively effective compared to SFSR. The predictive value of each risk score was increased when combined with S100B level. Conclusion: The OESIL and SFSR were ineffective in recognizing patients with adverse events because of relatively low sensitivity. Serum S100B level seems to be a promising biochemical test which may increase the utility of prognostic syncope risk scales.