How it's calculated
9 clinical, ECG, and diagnostic-impression criteria are each assigned a positive or negative point value and summed, for a total range of −3 to +11.
Risk categories
| Score | Risk category |
|---|---|
| −3 to −2 | Very low risk |
| −1 to 0 | Low risk |
| 1 to 3 | Medium risk |
| 4 to 5 | High risk |
| 6 to 11 | Very high risk |
Clinical use
- Predicts 30-day risk of a serious adverse event after an unexplained ED syncope presentation — arrhythmia, MI, structural heart disease, aortic dissection, pulmonary embolism, or death.
- Very-low/low-risk patients may be suitable for discharge with routine follow-up; higher-risk patients generally warrant further inpatient workup, monitoring, or expedited outpatient cardiology review per local protocol.
- Designed for patients presenting with syncope where the cause is not immediately obvious — not intended for a clearly identified single cause (e.g. an obvious vasovagal trigger with no other findings).
Frequently asked questions
What does the Canadian Syncope Risk Score predict?
The 30-day risk of a serious adverse event (arrhythmia, MI, structural heart disease, aortic dissection, pulmonary embolism, or death) following an emergency department presentation for syncope.
Can the score be negative?
Yes — features suggesting a benign vasovagal cause (predisposition to vasovagal symptoms, or an ED diagnosis of vasovagal syncope) subtract points, so the total can range from −3 up to +11.
What happens with a high-risk score?
Higher-risk patients generally warrant further inpatient workup, cardiac monitoring, or expedited outpatient cardiology follow-up, per local institutional protocol — this score supports, but doesn't replace, clinical judgement.
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:E289-E298.