Key result
Elevated R+S values and pathological ECG findings linked to higher 30-day mortality in syncope.
Why the study?
Syncope is a common reason for hospital admission with existing risk scores, but the effect of the R+S value and other ECG findings on 30-day prognosis needed investigation.
Do pathological ECG findings and elevated R+S values predict 30-day mortality in adults presenting to the emergency department with syncope of unknown cause?
Cohort (n=217)
Do pathological ECG findings and elevated R+S values predict 30-day mortality in adults presenting to the emergency department with syncope of unknown cause?
Specific pathological ECG findings, including elevated R+S values, are significant predictors of 30-day mortality in patients presenting to the emergency department with syncope.
Answers are grounded in this paper and cite their sources.
May support ECG risk stratification in ED syncope; hypothesis-generating and requires prospective validation.
BACKGROUND: Syncope is one of the most common reasons for hospital admission. Several risk scores exist for the follow-up, discharge, and hospitalization of such patients. AIM: To investigate the effect of the R+S value and other electrocardiography (ECG) findings on the 30-day prognosis of patients presenting to the emergency department with syncope of unknown cause. METHODS: This study examined 217 patients (116 males and 101 females) aged 18 years and older who presented to the emergency department with syncope. In the ECG, atrioventricular block, right or left bundle branch block, ventricular hypertrophy, QT interval prolongation, QRS duration prolongation, pathological Q wave, pathological ST-T changes, and arrhythmias were accepted as pathological. In addition, we collected the patients' chest ECG derivations in which the highest R wave was present, and the derivation in which the most profound S wave was present; these values were collected, and the maximum R+S values were recorded. The mortality status of the patients within 30 days was recorded. (The level of significance was set at P < 0.05). RESULTS: Patients with bundle branch block, arrhythmia, QRS prolongation, QT prolongation, and atrioventricular block in the ECG had a higher mortality rate (P < 0.05). We calculated the sum of the highest R+S values and found a significant relationship between the increase in this value and the increase in patient mortality (P = 0.002). CONCLUSION: Higher mortality was observed in patients with syncope who showed elevated R+S values, bundle branch block, arrhythmia, QRS prolongation, QT prolongation, and AV block in ECG.
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Kürtüncü et al. (2025) conducted a cohort in Syncope of unknown cause (n=217). Pathological ECG findings (including elevated R+S values) vs. Normal ECG findings / lower R+S values was evaluated on 30-day mortality (p=0.002). Elevated R+S values and pathological ECG findings like bundle branch block and arrhythmia were associated with higher 30-day mortality in patients with syncope.
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