Modified oesil (cane: cardiac history, age, neurological examination, ECG): can it be a new scoring system for evaluating patients presenting with syncope in the emergency department?

Objective: Syncope is a clinical condition characterized by sudden-onset, short-term loss of consciousness and constitutes a significant portion of emergency department visits. The aim of this study is to evaluate the effectiveness of the Modified OESIL (CANE: Cardiac History, Age, Neurological Examination, ECG) scoring system in predicting 1-month mortality by risk stratification of patients presenting with syncope. Materials and Methods: This observational prospective study was conducted between January 1, 2024, and July 1, 2024, on patients presenting with complaints of syncope to the Emergency Department of Bolu Abant İzzet Baysal University Hospital. Patients were classified into risk groups using the OESIL and Modified OESIL scoring systems, and 1-month mortality rates and hospital admissions were monitored and recorded. Results: In our study, 60.6% of participants did not experience a prodromal period, and it was found that 50% of patients who died after 1-month follow-up had abnormal neurological findings. The Modified OESIL score determined that 68.8% of discharged patients were in the low-risk group, while 70% of patients admitted to the ward and intensive care unit were in the high-risk group. The Modified OESIL scoring system was found to be more successful than the OESIL scoring system in predicting hospital admission for patients classified as high-risk. In our study, the OESIL score was found to have a significantly higher mortality rate in patients classified as clinically high-risk compared to the Modified OESIL scoring system. Conclusion: Although both scoring systems demonstrated limited performance, the OESIL score was more accurate in identifying patients with mortal outcomes, whereas the Modified OESIL score was more successful in evaluating the need for hospital admission in high-risk patients, thus assisting in clinical decision-making processes. These findings need to be validated with larger sample-sized studies. KEYWORDS: Syncope, OESIL, Scoring System, Mortality