ORIGINAL RESEARCH Open Access Predictor variables of abnormal imaging findings of syncope in the emergency department Kerem Ozturk 1* , Esra Soylu 2 , Cem Bilgin 1 , Bahattin Hakyemez 1 and Mufit Parlak 1 Abstract Background: This study aimed to describe the pathological findings and to analyze clinical predictors of abnormal imaging findings in patients presenting to the emergency department (ED) with syncope. Methods: The database was retrospectively reviewed for all patients who underwent cranial computed tomography (CT) or magnetic resonance imaging (MRI), having the symptom of syncope. Patients were included only if they were from the emergency department and excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor, or having a history of trauma. The primary outcome was assumed as abnormal head CT or MRI including intracranial hemorrhage, acute or subacute stroke, and newly diagnosed brain mass. Univariate and multivariate logistic regression analysis was utilized to determine the association between clinical variables and any significant pathology in either CT or MR scan. Results: Total of 1230 syncope (717 men and 513 women; range, 18–92 years; mean, 54.5 years) as presenting symptoms were identified in patients receiving either cranial CT or MR scan in the ED. Abnormal findings related to the syncope were observed in 47 (3.8%) patients. The following predictor variables were found to be significantly correlated with acutely abnormal head CT and MRI: a focal neurologic deficit, history of malignancy, hypertension, and age greater than 60 years. Conclusions: Our data offer that the identification of predictor variables has a potential to decrease the routine use of head CT and MRI in patients admitting to the ED with syncope. Keywords: Computed tomography (CT), Magnetic resonance imaging (MRI), Syncope, Emergency department (ED) Background Syncope, defined as a transient loss of consciousness, is a common clinical condition accounting for up to 3% of all emergency department (ED) visits and 6% of hospital admissions [1–4]. The identification of life-threatening conditions is challenging for the emergency physician [5]. In spite of detailed investigation, the specific cause could not be determined approximately 40% of cases [6, 7]. Along with these concerns, a reevaluation of the practice to obtain routine imaging methods in patients with syncope is required to reduce unnecessary and expensive medical testing [8]. Although computed tomographic (CT) and magnetic resonance imaging (MRI) scans of the head are often routinely utilized, only a few studies have examined their value to determine the severity of the disorders [9, 10]. Determining the clinical and laboratory variables associated with these decisions is a step toward progress for the assessment of patients admitting to the ED with syncope [11]. Therefore, we investigated consecutive patients who underwent head CT and MRI in the emergency depart- ment for syncope. Our purpose was to describe the pathological findings and to analyze predictor variables of pathological imaging findings in patients presenting to the emergency department with syncope. * Correspondence: keremozturk@uludag.edu.tr This study was orally presented at the European Congress of Radiology (ECR)–2017 and the Turkish society of Radiology Congress (TurkRad)–2016. 1 Department of Radiology, Faculty of Medicine, Uludag University, Bursa, Turkey Full list of author information is available at the end of the article International Journal of Emergency Medicine © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Ozturk et al. International Journal of Emergency Medicine (2018) 11:16 https://doi.org/10.1186/s12245-018-0180-0