canadian_syncope_risk_score: Canadian Syncope Risk Score (CSRS)

In cliot: Clinical Indices and Outcomes Tools

Canadian Syncope Risk Score (CSRS)

Description

Calculates the Canadian Syncope Risk Score to predict the 30-day risk of serious adverse events in patients presenting to the Emergency Department with syncope. The score integrates clinical evaluation, ECG/lab investigations, and the final ED diagnosis.

Usage

canadian_syncope_risk_score(vasovagal_predisposition, heart_disease_history,
                            sbp_any, sbp_ed, troponin_elevated,
                            axis_qrs_qt_abnormal, ed_diagnosis_cardiac,
                            ed_diagnosis_vasovagal)

Arguments

vasovagal_predisposition	Numeric (0 or 1). Clinical predispositions for vasovagal syncope (e.g., emotional distress, prolonged standing). (1 = Yes, -1 point).
heart_disease_history	Numeric (0 or 1). History of structural heart disease, arrhythmia, or CAD. (1 = Yes, +1 point).
sbp_any	Numeric (0 or 1). Was SBP < 90 or > 180 mmHg at any time during ED visit? (1 = Yes, +2 points). Note: The function argument 'sbp_ed' is kept for compatibility but logic uses 'sbp_any' as the primary flag for abnormal BP.
sbp_ed	Numeric. Included for flexibility, treated as redundant to sbp_any in standard scoring logic if binary flag used.
troponin_elevated	Numeric (0 or 1). Troponin level above 99th percentile. (1 = Yes, +2 points).
axis_qrs_qt_abnormal	Numeric (0 or 1). Abnormal QRS axis (<-30 or >100), duration (>130ms), or QTc (>480ms). (1 = Yes, +1 point).
ed_diagnosis_cardiac	Numeric (0 or 1). ED Physician diagnosis is Cardiac Syncope. (1 = Yes, +2 points).
ed_diagnosis_vasovagal	Numeric (0 or 1). ED Physician diagnosis is Vasovagal Syncope. (1 = Yes, -2 points).

Value

A list containing:

CSRS_Score	The calculated risk score (Range -3 to 11).
Risk_Category	Classification (Very Low, Low, Medium, High, Very High).
Est_30_Day_Serious_Outcome_Risk	Estimated percentage risk of serious adverse events.

References

Thiruganasambandamoorthy V, Kwong K, Wells GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events within 30 days of emergency department disposition. CMAJ. 2016;188(12):E289-E298. doi:10.1503/cmaj.151469

Examples

# Example 1: Very Low Risk
# Vasovagal predisposition (-1), ED Dx Vasovagal (-2)
# Score = -3
canadian_syncope_risk_score(1, 0, 0, 0, 0, 0, 0, 1)

# Example 2: High Risk
# Heart Disease (+1), Abnormal SBP (+2), Troponin (+2), Cardiac Dx (+2)
# Score = 7
canadian_syncope_risk_score(0, 1, 1, 0, 1, 0, 1, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.