🫀 Canadian Syncope Risk Score (CSRS)
UseGuide disposition after syncope without an obvious serious cause.
SourceThiruganasambandamoorthy V, et al. CMAJ 2016
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Low scores support discharge with follow-up.
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 | Vasovagal syncope (−2) |
→CSRS-2
- 30-day serious adverse event risk：Low (~0.4–0.7%)
- Disposition：Low risk — many can be discharged with follow-up.
| 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.
Verification & sources · governance
FAQ
Frequently asked questions
- 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.
- Does Canadian Syncope Risk Score (CSRS) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- 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 Vasovagal syncope (−2) → Result: CSRS -2（30-day serious adverse event risk: Low (~0.4–0.7%), Disposition: Low risk — many can be discharged with follow-up.） 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.）