Abstract
Background and objectiveDecision-making about syncope patients presenting to the emergency department (ED) is challenging since physicians must balance the minimal risks of life-threatening conditions with the unessential use of expensive imaging or unnecessary hospitalizations. This study aimed to determine the characteristics of ED visits, resource utilization, and admission rate patterns related to syncope in the United States (US) during the period 2005-2015.MethodsData from the National Hospital Ambulatory Medical Care Survey (NHAMCS) on ED visits during the 11-year period from 2005 to 2015 were retrieved. ED visits for syncope were identified and compared against non-syncope ED visits. The demographic and clinical characteristics of patients, as well data on resource allocation and admission trends were captured and described for the syncope and the non-syncope groups.ResultsSyncope accounted for 1.11% of the total ED visits during the study period from 2005 to 2015. The incidence of syncope-related ED visits was higher among elderly females, whites, and non-Hispanics. The trend of admission rates showed a decline from about 30% in 2005-2010 to less than 20% in 2014 and 2015. Advanced imaging (CT or MRI) was ordered for 34% of syncope patients.ConclusionThe percentage of syncope-related ED visits remained stable during the study period, but the admission rates declined while the use of advanced imaging in syncope-related ED visits remained substantially high despite the advances in research and availability of clinical guidelines. Future research is needed to rationalize healthcare utilization in syncope-related ED visits and precisely identify the high-risk population.
Highlights
Syncope is defined as a condition characterized by an abrupt, transient, and complete loss of consciousness followed by rapid and spontaneous recovery
Our study showed that a high proportion of syncope-related emergency department (ED) visits involved elderly females, whites, and non-Hispanics, which is similar to the findings of Sun et al [20] for the 1992-2000 period
Our study showed that hospital admission rates related to syncope ED visits decreased during the study period from about 30% in the five-year span of 2005-2010 to less than 20% in 2014 and 2015, which reflects an improvement in the identification of cases that require hospitalization
Summary
Syncope is defined as a condition characterized by an abrupt, transient, and complete loss of consciousness followed by rapid and spontaneous recovery. Syncope represents a common presentation to emergency departments (EDs) and is estimated to account for 0.6-1.7% of the total ED visits and hospital admission rates of 12-85% [1]. For many cases, further evaluation might be needed to investigate the cause of syncope and determine the appropriate management plan. Advanced imaging methods such as CT or MRI might be required to exclude central neurological causes of syncope. Decision-making about syncope patients presenting to the emergency department (ED) is challenging since physicians must balance the minimal risks of life-threatening conditions with the unessential use of expensive imaging or unnecessary hospitalizations. This study aimed to determine the characteristics of ED visits, resource utilization, and admission rate patterns related to syncope in the United States (US) during the period 2005-2015
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