Canadian Syncope Risk Score

Name: Canadian Syncope Risk Score calculator — MedScore
Creator: Nabil Alzein

30-day risk of serious outcomes after ED assessment of syncope (adults ≥ 16 years, within 24 h of the event)

Predisposition to vasovagal symptoms — −1

History of heart disease — +1

Any systolic blood pressure in the ED < 90 or > 180 mmHg — +2

Troponin above the 99th percentile of the normal population — +2

Abnormal QRS axis (< −30° or > 100°) — +1

QRS duration > 130 ms — +1

Corrected QT interval > 480 ms — +2

Diagnosis in the emergency department

Neither vasovagal nor cardiac — 0

Vasovagal syncope — −2

Cardiac syncope — +2

About this score

When to use

Predicts serious adverse events within 30 days after emergency department assessment of syncope, from nine predictors of the clinical evaluation, investigations and ED diagnosis (total −3 to 11). ⁦[1]⁩

Pearls and pitfalls

• Estimated 30-day serious outcomes: very low (−2 or less) 0.2%, low (−1 to 0) 0.7%, medium (1–3) 8%, high (4–5) 19% and very high (6 or more) 51%. ⁦[3]⁩

• It was derived in adults (16 or older) presenting to the emergency department within 24 hours of syncope. ⁦[3]⁩

Summarised from the numbered sources under Evidence. Check the source before relying on a statement.

Evidence

[1] Original publication

Thiruganasambandamoorthy V, Kwong K, Wells GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. Nine predictors from the clinical evaluation, investigations and the ED diagnosis; total −3 to 11.

CMAJ, 2016

Open source

[2] Validation

Thiruganasambandamoorthy V, Sivilotti MLA, Le Sage N, et al. Multicenter emergency department validation of the Canadian Syncope Risk Score. Prospective validation of the five risk categories for 30-day serious outcomes.

JAMA Internal Medicine, 2020

Open source

[3] Guideline

Meisenheimer ES, Rogers TS, Saguil A. Canadian Syncope Risk Score: a validated risk stratification tool. Table of points and categories used here: very low (≤ −2) 0.2 %, low (−1 to 0) 0.7 %, medium (1–3) 8 %, high (4–5) 19 %, very high (≥ 6) 51 % estimated 30-day serious outcomes, in adults (≥ 16 years) presenting to the ED within 24 h of syncope.

American Family Physician, 2021

Open source

Last reviewed: 2026-10

Report an error in this calculator

MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.