Publication: Utility of serum S100B level, SFSR and OESIL scores in anticipating short term adverse events of discharged syncope patients
Abstract
Amaç: Serum S100β değerini OESIL ve San Fransisko Senkop Kuralı (SFSK) gibi senkop klinik karar verme kurallarıyla birleştirerek erken dönem (10 gün) advers olay riskini belirlemede sağladığı faydayı belirlemeyi hedefledik. Gereç ve Yöntemler: Bu gözlemsel prospektif kohort çalışmasına, 2005 Haziran ve 2007 Ocak ayları arasında Marmara Üniversitesi Acil Servisine son 48 saat içerisinde bayılma şikayetiyle başvuran, 18 yaşından büyük ve dışlanma kriterlerini içermeyen tüm hastalar dahil edilmiştir. Taranan 254 hastadan 80i çalışmaya dahil edilmiş, 62si çalışmayı tamamlamıştır. OESIL ve SFSKnın parametreleri ve serum S100β değeri çoklu regresyon analizi ile incelenerek erken dönemde herhangi bir advers olay olasılığını öngördürecek bir risk skoru geiştirilmeye çalışılmıştır. Bulgular: Erken dönemde advers olay görülen hastaların başvuru esnasında daha yüksek nabız hızı, daha düşük hematokrit ve hemoglobin düzeyleri ve daha yüksek serum S100β düzeyine sahip oldukları belirlenmiştir. OESIL skoru, SFSK ve S100β düzeylerinin kesinlikleri (accuracy) arasında istaitstiksel olarak anlamlı fark tespit edilmemiştir. Prodromal semptom olmaması, anormal EKG varlığı ve yüksek serum S100β düzeyi advers olayı belirleyebilecek regresyon modeline anlamlı katkıda bulunan değişkenler olarak belirlenmişlerdir. OESIL isk skoru ve S100B düzeyi SFSK ile karşılaştırıldığında nispeten daha etkin gibi görünmektedirler. Öte yandan, her skorun prediktif değeri S100B ile birleştirildiğinde yükselmektedir. Sonuç: OESIL risk skoru ve SFSK erken dönemde advers olay geçirmesi muhemel hastaları belirlemede düşük duyarlılıkları sebebiyle yeterli değillerdir. Öte yandan, serum S100B düzeyi bu progrnostik risk skorlarının değerliliğini arttıracak bir biyokimyasal test olabilir. (JAEM 2013; 12: 1-7)
Objective: Our aim is to evaluate S100β in serum in addition to clinical synope decision rules and to determine the utility of this parameter along witOESIL and SFSR for any short term (10 days) adverse events. Material and Methods: This observational prospective cohort study includd all consecutive patients older than 18 years who presented to the ED oMarmara University Hospital between June 2005 and January 2007 with thomplaint of syncope within the previous 48 hours unless they had exclusion riteria. Two hundred and fifty-four patients were admitted, 80 were enrolled nd 62 completed the follow-up. Multivariable logistic regression analysiwas used to develop a risk score to predict the probability any adverse evenn the short term using parameters of OESIL risk score, SFSR and serum S-100β evel. Results: Patients with any short term adverse events had a higher pulse rateower hematocrit and hemoglobin levels, and higher serum S100B levels on dmission. There were no significant differences between the accuracies oOESIL, SFS Rule and S100B level. Absence of prodromal symptoms, abnormaCG and high serum S100B level were significant contributors of the model odverse events. OESIL and S100B level were relatively effective compared tFSR. 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 dverse events because of relatively low sensitivity. Serum S100B level seemo be a promising biochemical test which may increase the utility of prognos
Objective: Our aim is to evaluate S100β in serum in addition to clinical synope decision rules and to determine the utility of this parameter along witOESIL and SFSR for any short term (10 days) adverse events. Material and Methods: This observational prospective cohort study includd all consecutive patients older than 18 years who presented to the ED oMarmara University Hospital between June 2005 and January 2007 with thomplaint of syncope within the previous 48 hours unless they had exclusion riteria. Two hundred and fifty-four patients were admitted, 80 were enrolled nd 62 completed the follow-up. Multivariable logistic regression analysiwas used to develop a risk score to predict the probability any adverse evenn the short term using parameters of OESIL risk score, SFSR and serum S-100β evel. Results: Patients with any short term adverse events had a higher pulse rateower hematocrit and hemoglobin levels, and higher serum S100B levels on dmission. There were no significant differences between the accuracies oOESIL, SFS Rule and S100B level. Absence of prodromal symptoms, abnormaCG and high serum S100B level were significant contributors of the model odverse events. OESIL and S100B level were relatively effective compared tFSR. 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 dverse events because of relatively low sensitivity. Serum S100B level seemo be a promising biochemical test which may increase the utility of prognos