ROSE rule for syncope

Definition

• Rule-out clinical decision aid for assessing the risk of serious events in undifferentiated syncope

Criteria

• BNP concentration of at least 300 pg/mL (odds ratio 7.3)
• Positive rectal exam for fecal occult blood in patients with suspected gastrointestinal bleeding (OR 13.2)
• Hemoglobin no greater than 90 g/L (OR 6.7)
• Q waves on electrocardiogram (but not in lead III) (OR 2.8)
• Left bundle branch block on electrocardiogram (OR 4.8)
• Oxygen saturation no greater than 94% on room air (OR 3.0)

Use

• If any criteria are positive, you should strongly consider admitting the patient for inpatient monitoring and evaluation

See Also

• San Francisco Syncope Rule