🫀 Canadian Syncope Risk Score (CSRS)
Predict 30-day serious outcomes after ED syncope with the CSRS.
Low scores support discharge with follow-up.
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When to use
Guide disposition after syncope without an obvious serious cause.
How it works
Vasovagal predisposition (−1), heart disease (1), SBP < 90/>180 (2), troponin > 99th (2), abnormal QRS axis (1), QRS > 130 ms (1), QTc > 480 ms (2), ED diagnosis vasovagal (−2)/cardiac (2). Range −3 to 11.
Key points
- Low scores support discharge with follow-up.
- High scores warrant monitoring and cardiology input.
- Applies after initial ED assessment.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Predisposition to vasovagal symptoms | No |
|---|---|
| History of heart disease | No |
| Any SBP < 90 or > 180 mmHg | No |
| Troponin > 99th percentile | No |
| Abnormal QRS axis | No |
| QRS duration > 130 ms | No |
| QTc > 480 ms | No |
| ED diagnosis | Neither (0) |
→CSRS0
- 30-day serious adverse event risk：Low-medium (~1.9%)
- Disposition：Low risk — many can be discharged with follow-up.
| Predisposition to vasovagal symptoms | Yes (−1) |
|---|---|
| History of heart disease | Yes (+1) |
| Any SBP < 90 or > 180 mmHg | Yes (+2) |
| Troponin > 99th percentile | Yes (+2) |
| Abnormal QRS axis | Yes (+1) |
| QRS duration > 130 ms | Yes (+1) |
| QTc > 480 ms | Yes (+2) |
| ED diagnosis | Cardiac syncope (+2) |
→CSRS10
- 30-day serious adverse event risk：Very high (~28%+)
- Disposition：Higher risk — consider monitoring/admission and cardiology input.
Frequently asked questions
- What is Canadian Syncope Risk Score (CSRS)?
- Predict 30-day serious outcomes after ED syncope with the CSRS.
- How is Canadian Syncope Risk Score (CSRS) calculated? What is the core formula?
- Vasovagal predisposition (−1), heart disease (1), SBP < 90/>180 (2), troponin > 99th (2), abnormal QRS axis (1), QRS > 130 ms (1), QTc > 480 ms (2), ED diagnosis vasovagal (−2)/cardiac (2). Range −3 to 11.
- When is Canadian Syncope Risk Score (CSRS) used?
- Guide disposition after syncope without an obvious serious cause.
- What are the key clinical points for Canadian Syncope Risk Score (CSRS)?
- Low scores support discharge with follow-up. High scores warrant monitoring and cardiology input. Applies after initial ED assessment.
- What are the limits and cautions when using Canadian Syncope Risk Score (CSRS)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Canadian Syncope Risk Score (CSRS) calculated in practice? Can you show a worked example?
- Inputs: Predisposition to vasovagal symptoms No, History of heart disease No, Any SBP < 90 or > 180 mmHg No, Troponin > 99th percentile No, Abnormal QRS axis No, QRS duration > 130 ms No, QTc > 480 ms No, ED diagnosis Neither (0) → Result: CSRS 0（30-day serious adverse event risk: Low-medium (~1.9%), Disposition: Low risk — many can be discharged with follow-up.） Inputs: Predisposition to vasovagal symptoms Yes (−1), History of heart disease Yes (+1), Any SBP < 90 or > 180 mmHg Yes (+2), Troponin > 99th percentile Yes (+2), Abnormal QRS axis Yes (+1), QRS duration > 130 ms Yes (+1), QTc > 480 ms Yes (+2), ED diagnosis Cardiac syncope (+2) → Result: CSRS 10（30-day serious adverse event risk: Very high (~28%+), Disposition: Higher risk — consider monitoring/admission and cardiology input.）