Abstract 11339: Rates of Hospital Admissions for Syncope in the United States Using a National Database

Abstract

Introduction: Syncope accounts for 1% of emergency department (ED) visits, and a significant proportion of patients become hospitalized. Most causes of syncope are benign and can be evaluated in the outpatient setting. The yield for hospitalization and inpatient workup of syncope is low. In this study, we sought to characterize trends of syncope ED visits resulting in hospitalizations. Methods: We used data from the IBM MarketScan Research Database, which captures de-identified individual-level health data from approximately 100 commercial payers and self-insured corporations in the United States, not including Medicaid claims. We identified patients presenting to the ED for syncope from 2010-2020 using ICD-9 and ICD-10 codes. Subsequently, the number of hospital ED admissions (both observation and inpatient admissions) was calculated. Results: We identified 1,737,382 ED visits from 2010-2020. There was a significant reduction in hospital admissions for syncope (11.5% to 1.4%, p<0.001). In contrast, observation rates increased (5.4% to 8.5%, p<0.001), figure 1A. The rate of discharge home from the ED increased (83.1% to 90.1%, p<0.001). The same trends were seen for patients younger or older than 65 years, figures 1B and 1C, respectively. Nonetheless, the admission or observation rate was significantly higher for older patients (15.5% vs. 8.6%, p<0.001). Conclusions: Hospital admissions for syncope declined over the past decade. There is a need to assess if this has affected mortality or recurrent ED visits for syncope.