New Decision Rule for Syncope Safely Reduces Hospitalizations

The cost of syncope hospitalizations in the U.S. is roughly $2 billion per year. Investigators assessed the effectiveness and safety of a clinical decision rule (the Boston Syncope Criteria) to identify syncope patients at risk for adverse outcomes. In a prospective study at a single emergency department (ED), the investigators enrolled 293 adults who presented with syncope (defined as loss of consciousness for <5 minutes with spontaneous recovery), and were managed at physician discretion before implementation of the rule, and 277 adults who presented after implementation.

The rule recommends admission for patients with acute coronary syndrome, conduction disease, worrisome cardiac history (e.g., dysrhythmia, pacemaker), valvular heart dise…