• J Clin Med · Feb 2020

    Role of Biomarkers in the Prediction of Serious Adverse Events after Syncope in Prehospital Assessment: A Multi-Center Observational Study.

    • Francisco Martín-Rodríguez, Carlos Del Pozo Vegas, Alicia Mohedano-Moriano, Begoña Polonio-López, Clara Maestre Miquel, Antonio Viñuela, Durantez FernándezCarlosCFaculty of Health Sciences. Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain., Gómez CorreasJesúsJFaculty of Health Sciences. Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain., Raúl López-Izquierdo, and José Luis Martín-Conty.
    • Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid. Advanced Life Support Unit, Emergency Medical Services, Valladolid 47005, Spain.
    • J Clin Med. 2020 Feb 28; 9 (3).

    AbstractSyncope is defined as the nontraumatic, transient loss of awareness of rapid onset, short duration and with complete spontaneous recovery, and accounts for 1%-3% of all visits to the emergency department. The objective of this study was to evaluate the predictive capacity of the National Early Warning Score 2 (NEWS2) and prehospital lactate (pLA), individually and combined, at the prehospital level to detect patients with syncope at risk of early mortality (within 48 h) in the hospital environment. A prospective, multicenter cohort study without intervention was carried out on syncope patients aged over 18 who were given advanced life support and taken to the hospital. Our study included a total of 361 cases. Early mortality affected 21 patients (5.8%). The combined score formed by the NEWS2 and the pLA (NEWS2-L) obtained an AUC of 0.948 (95% CI: 0.88-1) and an odds ratio of 86.25 (95% CI: 11.36-645.57), which is significantly higher than that obtained by the NEWS2 or pLA in isolation (p = 0.018). The NEWS2-L can help stratify the risk in patients with syncope treated in the prehospital setting, with only the standard measurement of physiological parameters and pLA.

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