Syncope Outcomes After Emergency Department Discharge
There was variation in 30-day ED revisits for syncope from 1.2% to 2.4%.
HealthDay News — Most patients presenting to the emergency department (ED) with a primary diagnosis of syncope are discharged and have a favorable prognosis, and though total costs to care for discharged syncope patients are high, cost per patient is lower compared with hospitalized patients, according to a study published online in JACC: Clinical Electrophysiology.
Roopinder K. Sandhu, MD, MPH, from the University of Alberta in Canada, and colleagues examined outcomes and costs for 51,831 consecutive patients presenting to the ED with a primary diagnosis of syncope from 2006-2014.
The researchers found that 6.6% of patients were hospitalized and discharged with a primary diagnosis of syncope (cohort 1), 8.7% were hospitalized and discharged with a primary diagnosis other than syncope (cohort 2), and 84.7% were discharged home from the ED with a diagnosis of syncope (cohort 3). There was variation in 30-day ED revisits for syncope from 1.2% to 2.4% for cohorts 2 and 1, respectively; readmission rates were below 1% among the cohorts.
Short- and long-term mortality rates were highest and lowest for cohorts 2 and 3, respectively (30-day mortality: 1.2%, 5.2%, and 0.4% for cohorts 1, 2, and 3, respectively; 1-year mortality: 9.2%, 17.7%, and 3%, respectively). The total cost of syncope presentation was $534.8 million ($76.7 million, $139.4 million, and $318.7 million for cohorts 1, 2, and 3, respectively).
"Further research is needed for cost-saving strategies across all cohorts," the authors write.
Sandhu RK, Tran DT, Sheldon RS, Kaul P. A population-based cohort study evaluating outcomes and costs for syncope presentations to the emergency department [published online November 2, 2017]. JACC Clin Electrophysiol. doi:10.1016/j.jacep.2017.09.003