Cost of diagnosis and treatment of syncope in patients admitted to a cardiology unit

Aims Despite the large number of hospital admissions due to syncope, information on the in-hospital cost of management of these patients remains incomplete. Methods and results In order to assess such cost, we analysed the clinical histories of the patients suffering from syncope who were admitted to our Unit of Cardiology in 2003. We determined the length of stay (in days) for each inpatient, the number of diagnostic tests performed, and the various therapeutic procedures undertaken. Two hundred and three patients (mean age 68 +/- 14, 49% female) were admitted because of syncope. Final diagnoses on discharge were drug-induced syncope in 10 patients, vasovagal syncope in 11, syncope secondary to cardiac ischaemia in 18, valvular disease in 4, rapid supraventricular arrhythmia in 20, ventricular arrhythmia in 19, atrioventricular block in 90, and unexplained syncope in 31 patients. Of these 203 patients, 70 (34.5%) had a previous history of cardiac disease. The global cost for all 203 patients was 2 264 979EURO. The overall cost per patient was 11 158EURO (range: 1651-31 762) including stay, diagnosis, and treatment. The overall cost of hospital stay per patient was 3718EURO (range: 1436-5679). The overall cost per diagnosis of the 203 patients was 1141EURO (range: 155-3577), and the cost of the therapeutic procedures required was 6299EURO (range: 0-23 115). The most expensive were those cases of syncope secondary to ventricular arrhythmia, the cost of which is 20 times that of drug-induced syncope. Conclusion The cost per diagnosis and treatment of a patient admitted because of syncope varies widely with important differences depending on the specific cause.