What are the ROSE (Risk stratification Of Syncope in the Emergency department) criteria for predicting serious outcomes in syncope?

Updated: Jan 13, 2017
  • Author: Rumm Morag, MD, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

The ROSE (Risk stratification Of Syncope in the Emergency department) criteria suggested that an elevated B-type natriuretic peptide (BNP), Hemoccult-positive stool, anemia, low oxygen saturation, and presence of Q waves on ECG predict serious outcomes at 30 days. [22]  These rules had a 87% sensitivity and a 98.5% negative predictive value to help risk-stratify patients. In this study, the isolated finding of BNP greater than 300 pg/mL was a major predictor of serious outcomes and was present in 89% of patients who died within 30 days.

Constantino et al discovered that 6.1% of patients had severe outcomes within 10 days of syncope evaluation. [23]  The mortality was 0.7%, and 5.4% of patients were readmitted or experienced major therapeutic intervention. Risk factors associated with severe short-term outcomes included abnormal ECG, history of CHF, age older than 65 years, male gender, history of chronic obstructive pulmonary disease (COPD), structural heart disease, presence of trauma, and lack of prodromal symptoms.


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