Comparison of Anatolian and San francisco risk scores in predicting the prognosis of patients presenting to the emergency department with syncope

Aim: This study aimed to compare the effectiveness of the Anatolian Syncope Rule (ASR) and the San Francisco Syncope Rule (SFSR) in predicting short-term prognosis among patients admitted to the emergency department with syncope. Material and Method: This retrospective descriptive study included 244 adult patients who August 1, 2021, and July 31, 2023. Demographic characteristics, vital signs, comorbidities, ECG findings, hematocrit levels, and one-month mortality data were collected from medical records. Risk stratification was performed using SFSR and ASR criteria. Predictive performance for short-term mortality was analyzed using ROC curves, with sensitivity, specificity, positive and negative predictive values calculated. Results: The median age of patients was 65 years, and 55.3% were male. One-month mortality was 12.3%. Adverse outcomes were detected in 66.8% of patients with high SFSR scores and 82% with high ASR scores. Both scoring systems significantly predicted short-term mortality, but the ASR showed a higher area under the ROC curve (AUC) than the SFSR. Conclusion: The Anatolian Syncope Rule demonstrated superior diagnostic accuracy compared to the San Francisco Syncope Rule in predicting short-term mortality in patients with syncope. ASR may serve as a practical and reliable risk assessment tool for the Turkish emergency population.