{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:32:31Z","timestamp":1786649551988,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Syncope is one of the most common reasons for hospital admission. Several risk scores exist for the follow-up, discharge, and hospitalization of such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To investigate the effect of the R+S value and other electrocardiography (ECG) findings on the 30-day prognosis of patients presenting to the emergency department with syncope of unknown cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This study examined 217 patients (116 males and 101 females) aged 18 years and older who presented to the emergency department with syncope. In the ECG, atrioventricular block, right or left bundle branch block, ventricular hypertrophy, QT interval prolongation, QRS duration prolongation, pathological Q wave, pathological ST-T changes, and arrhythmias were accepted as pathological. In addition, we collected the patients\u2019 chest ECG derivations in which the highest R wave was present, and the derivation in which the most profound S wave was present; these values were collected, and the maximum R+S values were recorded. The mortality status of the patients within 30 days was recorded. (The level of significance was set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients with bundle branch block, arrhythmia, QRS prolongation, QT prolongation, and atrioventricular block in the ECG had a higher mortality rate (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). We calculated the sum of the highest R+S values and found a significant relationship between the increase in this value and the increase in patient mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Higher mortality was observed in patients with syncope who showed elevated R+S values, bundle branch block, arrhythmia, QRS prolongation, QT prolongation, and AV block in ECG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njcp.njcp_243_25","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T13:01:18Z","timestamp":1767013278000},"page":"1420-1427","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Electrocardiography Findings on 30-day Mortality among Patients Treated for Syncope in the Emergency Department"],"prefix":"10.4103","volume":"28","author":[{"given":"\u0130","family":"K\u00fcrt\u00fcnc\u00fc","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Kayseri City Hospital Affiliate with University of Health Sciences, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Sahin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kayseri City Hospital Affiliate with University of Health Sciences, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AF","family":"Nalbant","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kayseri City Hospital Affiliate with University of Health Sciences, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FH","family":"Celik","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kayseri City Hospital Affiliate with University of Health Sciences, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"R1-20260116","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1001\/jamainternmed.2020.0288","article-title":"Multicenter emergency department validation of the Canadian syncope risk score","volume":"180","author":"Thiruganasambandamoorthy","year":"2020","journal-title":"JAMA Intern Med"},{"key":"R2-20260116","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1093\/eurheartj\/ehy037","article-title":"2018 ESC guidelines for the diagnosis and management of syncope","volume":"39","author":"Brignole","year":"2018","journal-title":"Eur Heart J"},{"key":"R3-20260116","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jacep.2019.11.002","article-title":"A population-based study evaluating sex differences in patients 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Implementation of a simplified diagnostic algorithm in a multicentre prospective trial - the OESIL 2 study (Osservatorio Epidemiologico della Sincope nel Lazio)","volume":"21","author":"Ammirati","year":"2000","journal-title":"Eur Heart J"},{"key":"R14-20260116","doi-asserted-by":"crossref","first-page":"E289","DOI":"10.1503\/cmaj.151469","article-title":"Development of the Canadian syncope risk score to predict serious adverse events after emergency department assessment of syncope","volume":"188","author":"Thiruganasambandamoorthy","year":"2016","journal-title":"CMAJ"},{"key":"R15-20260116","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1136\/emermed-2018-207767","article-title":"Approach to syncope in the emergency department","volume":"36","author":"Reed","year":"2019","journal-title":"Emerg Med J"},{"key":"R16-20260116","doi-asserted-by":"crossref","first-page":"e155","DOI":"10.1016\/j.hrthm.2017.03.004","article-title":"2017 ACC\/AHA\/HRS guideline for the evaluation and management of patients with syncope: A report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"14","author":"Shen","year":"2017","journal-title":"Heart Rhythm"},{"key":"R17-20260116","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1016\/j.hrthm.2014.06.037","article-title":"Prognostic value of the electrocardiogram in patients with syncope: Data from the group for syncope study in the emergency room (GESINUR)","volume":"11","author":"P\u00e9rez-Rodon","year":"2014","journal-title":"Heart Rhythm"},{"key":"R18-20260116","doi-asserted-by":"crossref","first-page":"e007564","DOI":"10.1161\/JAHA.117.007564","article-title":"Combining ECG criteria for left ventricular hypertrophy improves risk prediction in patients with hypertension","volume":"6","author":"Okin","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"R19-20260116","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s10286-024-01089-2","article-title":"Trends in syncope testing and admissions in the USA from 2006 through 2019","volume":"35","author":"Ruzieh","year":"2025","journal-title":"Clin Auton Res"},{"key":"R20-20260116","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/acem.13842","article-title":"Predictive accuracy of electrocardiographic monitoring of patients with syncope in the emergency department: The SyMoNE multicenter study","volume":"27","author":"Solbiati","year":"2020","journal-title":"Acad Emerg Med Off J Soc Acad Emerg Med"},{"key":"R21-20260116","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/j.1553-2712.2011.01120.x","article-title":"Electrocardiogram findings in emergency department patients with syncope","volume":"18","author":"Quinn","year":"2011","journal-title":"Acad Emerg Med Off J Soc Acad Emerg Med"},{"key":"R22-20260116","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/HPC.0000000000000146","article-title":"A new feasible syncope risk score appropriate for emergency department: A prospective cohort study","volume":"17","author":"Bozorgi","year":"2018","journal-title":"Crit Pathw Cardiol"},{"key":"R23-20260116","first-page":"101143","article-title":"Lifetime prevalence and correlates of syncope in five ancestry groups. The HELIUS study","volume":"43","author":"Brewster","year":"2022","journal-title":"Int J Cardiol Heart Vasc"},{"key":"R24-20260116","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.3390\/medicina57111235","article-title":"Syncope time frames for adverse events after emergency department presentation: An individual patient data meta-analysis","volume":"57","author":"Furlan","year":"2021","journal-title":"Medicina (Kaunas)"},{"key":"R25-20260116","doi-asserted-by":"crossref","first-page":"1251637","DOI":"10.1155\/2016\/1251637","article-title":"Diagnostic yield of echocardiography in syncope patients with normal ECG","volume":"2016","author":"Chang","year":"2016","journal-title":"Cardiol Res Pract"},{"key":"R26-20260116","doi-asserted-by":"crossref","first-page":"5441670","DOI":"10.1155\/2021\/5441670","article-title":"Relationship between a prolonged corrected QT interval and mortality in patients presenting with syncope at the emergency department","volume":"2021","author":"Akyol","year":"2021","journal-title":"Biomed Res Int"},{"key":"R27-20260116","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1161\/CIRCULATIONAHA.118.036088","article-title":"Duration of Electrocardiographic Monitoring of Emergency Department Patients With Syncope","volume":"139","author":"Thiruganasambandamoorthy","year":"2019","journal-title":"Circulation"},{"key":"R28-20260116","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S0196-0644(97)70217-8","article-title":"Risk stratification of patients with syncope","volume":"29","author":"Martin","year":"1997","journal-title":"Ann Emerg Med"},{"key":"R29-20260116","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s11886-022-01757-7","article-title":"Cardiac and vascular causes of syncope and atherosclerosis","volume":"24","author":"da","year":"2022","journal-title":"Curr Cardiol Rep"},{"key":"R30-20260116","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.recesp.2022.11.010","article-title":"Arrhythmic risk in single or recurrent episodes of unexplained syncope with complete bundle branch block","volume":"76","author":"Francisco-Pascual","year":"2023","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"R31-20260116","first-page":"e41370","article-title":"Heart rate variability in unexplained syncope patients versus healthy controls: A comparative study","volume":"15","author":"Dash","year":"2023","journal-title":"Cureus"},{"key":"R32-20260116","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1097\/MCA.0000000000001061","article-title":"Relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious coronary artery anomalies","volume":"31","author":"Kalkan","year":"2022","journal-title":"Coron Artery Dis"}],"container-title":["Nigerian Journal of Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/njcp.njcp_243_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:19Z","timestamp":1786647319000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/njcp.njcp_243_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":32,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/njcp.njcp_243_25","relation":{},"ISSN":["1119-3077","2229-7731"],"issn-type":[{"value":"1119-3077","type":"print"},{"value":"2229-7731","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-04-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}