ROSE Rule (syncope 1-month serious outcome)
ROSE rule (Reed 2010) for syncope: any of BNP >= 300, bradycardia <= 50, fecal occult blood, anemia (Hgb <= 9 g/dL), chest pain, ECG Q wave, or SpO2 <= 94% flags high risk of 1-month serious outcome or death.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- BNP >= 300 pg/mL
- Yes
Result: High risk (1 positive criterion): 1-month serious outcome or death possible -- consider admission.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Verdict
- any single positive criterion predicts a 1-month serious outcome or death; all-negative is low risk (NPV ~98.5%). Cross-links egsys, oesil.
What you enter
- BNP >= 300 pg/mL
- Bradycardia <= 50 bpm
- Fecal occult blood on rectal exam
- Anemia (hemoglobin <= 9.0 g/dL)
- Chest pain with syncope
- ECG Q wave (not lead III)
- Oxygen saturation <= 94% on room air
How this is calculated
- Criteria
- BRACES + bradycardia: BNP >= 300 pg/mL, bradycardia <= 50, rectal fecal-occult-blood positive, anemia (Hgb <= 90 g/L), chest pain, ECG Q wave (not lead III), saturation <= 94%.
Reed MJ, Newby DE, Coull AJ, et al. The ROSE (Risk Stratification of Syncope in the Emergency Department) study. J Am Coll Cardiol. 2010;55(8):713-721. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.