Syncope risk stratification in the emergency department

The overall risk for a patient entering the emergency department (ED) because of syncope ranges between 5% and 15%, and the mortality at 1 week is approximately 1%. The primary goal for the ED physician is thus to discriminate individuals at low risk, who can be safely discharged, from patients at high risk, who warrant a prompt hospitalization for monitoring and/or appropriate treatment. Different rules and risk scores have been proposed. More ad hoc studies are needed to define the prognostic and diagnostic roles of the brain natriuretic peptide and other noninvasive laboratory markers.