Syncope: Outcomes and Conditions Associated with Hospitalization

Area of Science:

• Cardiology
• Internal Medicine
• Public Health

Background:

• Syncope (fainting) presents a diagnostic challenge, leading to frequent hospitalizations and readmissions with uncertain outcomes.
• Understanding the epidemiology and clinical impact of syncope admissions is crucial for improving patient care and resource allocation.

Purpose of the Study:

• To determine the incidence of hospital admissions and readmissions for syncope.
• To compare associated conditions, in-hospital outcomes, and resource utilization for syncope admissions.

Main Methods:

• Utilized the 2005-2011 California Statewide Inpatient Database for patients aged 18+ admitted with syncope (ICD-9 code 780.2).
• Classified admissions as primary syncope based on discharge diagnosis.
• Assessed primary outcome (mortality) and secondary outcomes including adverse events, length of stay, and hospital charges.

Main Results:

• Syncope accounted for an estimated 1.52% of annual admissions; 42.1% had unknown causes, and 23% were recurrent episodes.
• Mortality was significantly lower in primary syncope (0.2%) versus secondary syncope (1.4%). Key mortality risk factors included pulmonary hypertension and metastatic cancer.
• Hospital charges for syncope admissions increased by 1.5 times over a decade, despite decreasing adverse events in patients with multiple admissions.

Conclusions:

• Syncope is a frequent cause of hospitalization, particularly in the elderly, despite a generally good prognosis.
• Current diagnostic evaluation strategies for syncope are expensive and often lack sufficient diagnostic value.
• Further research is needed to develop cost-effective and diagnostically efficient methods for evaluating syncope patients.