by Whitecoat
The Journal of the American College of Cardiology presented the ROSE study for triaging patients with syncope in the emergency department. No, ROSE isn’t some LOL that the study was named after. ROSE is an acronym standing for “Risk Stratification of Syncope in the Emergency Department.” They just left out a few letters because an acronym of “RSOSITED” just isn’t quite as catchy. Maybe SOS-ED would have been cooler, but ROSE it is.
Anyway, the study looked at what factors were likely to be present in patients who passed out and who had a “serious outcome” or death in the following month. Serious outcomes or death occurred in 7% of all patients who passed out in this study. They found that positive fecal occult blood, low hemoglobin levels, low oxygen saturation, and Q waves on the EKG were all predictive of worse prognosis for patients with syncope.
In addition, a BNP (brain natriuretic peptide) level greater than 300 was present in 36% of syncopal patients who later suffered serious cardiovascular events and in 89% of syncopal patients who later died.
More than 98% of patients who had none of these risk factors also had no serious outcome or death in the subsequent month after their syncopal event.
So check the BNP on syncope patients and get out those rubber gloves, ladies and gents. Add syncope to the list of patient complaints for which rectal exams may be indicated.
After all this, if you’re still wondering what “LOL who DFO” means, then you have to read this religious post.
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