TY - JOUR
T1 - Incidence and Mortality Rates of Syncope in the United States
AU - Alshekhlee, Amer
AU - Shen, Win Kuang
AU - Mackall, Judith
AU - Chelimsky, Thomas C.
PY - 2009/2
Y1 - 2009/2
N2 - Purpose: Syncope is a common cause of hospitalization in the US. The main objective of this study is to determine the incidence and mortality rates when patients are admitted with a principle diagnosis of syncope. Methods: An observational cross-sectional study included patients with the principle diagnosis of syncope identified from the National Inpatient Sample database for the years 2000-2005. Incidence rate of syncope was adjusted according to the US Census data. In-hospital mortality and its predictors were identified by a logistic regression analysis, and Cochran-Armitage test was used for trend analysis. Results: After data cleansing, 305,932 patients were included in the analysis. Adjusted incidence rate of syncope varied between 0.80 and 0.93 per 1000 person-years and was unchanged over the years included in the analysis. Overall mortality rate is 0.28%, a trend that has not changed over the years (P = 0.07). The odds ratio (OR) of death increased with age, becoming more prominent after age 40 years. Hospital mortality is higher in men (OR 1.49; 95% confidence interval [CI], 1.30-1.71) and in patients with higher comorbidity index (OR 1.39; 95% CI, 1.20-1.62) for moderate, and (OR 4.14; 95% CI, 3.05-5.61) for severe comorbidity index. The median cost of hospitalization is $8579, which increased by 3- to 11-fold if patients had a cardiac pacemaker or implantable cardioverter-defibrillator. Conclusions: Syncope remains a common cause of hospital admission. The hospital mortality rate for syncope is low. A better definition and a nationally implemented care path for syncope diagnosis could provide a substantial cost savings.
AB - Purpose: Syncope is a common cause of hospitalization in the US. The main objective of this study is to determine the incidence and mortality rates when patients are admitted with a principle diagnosis of syncope. Methods: An observational cross-sectional study included patients with the principle diagnosis of syncope identified from the National Inpatient Sample database for the years 2000-2005. Incidence rate of syncope was adjusted according to the US Census data. In-hospital mortality and its predictors were identified by a logistic regression analysis, and Cochran-Armitage test was used for trend analysis. Results: After data cleansing, 305,932 patients were included in the analysis. Adjusted incidence rate of syncope varied between 0.80 and 0.93 per 1000 person-years and was unchanged over the years included in the analysis. Overall mortality rate is 0.28%, a trend that has not changed over the years (P = 0.07). The odds ratio (OR) of death increased with age, becoming more prominent after age 40 years. Hospital mortality is higher in men (OR 1.49; 95% confidence interval [CI], 1.30-1.71) and in patients with higher comorbidity index (OR 1.39; 95% CI, 1.20-1.62) for moderate, and (OR 4.14; 95% CI, 3.05-5.61) for severe comorbidity index. The median cost of hospitalization is $8579, which increased by 3- to 11-fold if patients had a cardiac pacemaker or implantable cardioverter-defibrillator. Conclusions: Syncope remains a common cause of hospital admission. The hospital mortality rate for syncope is low. A better definition and a nationally implemented care path for syncope diagnosis could provide a substantial cost savings.
KW - Cardioverter-defibrillator
KW - Incidence
KW - Mortality
KW - Pacemaker
KW - Syncope
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U2 - 10.1016/j.amjmed.2008.08.024
DO - 10.1016/j.amjmed.2008.08.024
M3 - Article
C2 - 19100958
AN - SCOPUS:58749086551
SN - 0002-9343
VL - 122
SP - 181
EP - 188
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 2
ER -