Incidence and Mortality Rates of Syncope in the United States

被引:65
作者
Alshekhlee, Amer [1 ]
Shen, Win-Kuang [2 ]
Mackall, Judith [3 ]
Chelimsky, Thomas C. [1 ]
机构
[1] Case Western Reserve Univ, Univ Hosp, Case Med Ctr, Neurol Inst Auton Lab, Cleveland, OH 44106 USA
[2] Mayo Clin, Div Cardiovasc Dis, Rochester, MN USA
[3] Case Western Reserve Univ, Univ Hosp, Case Med Ctr, Dept Cariol, Cleveland, OH 44106 USA
关键词
Cardioverter-defibrillator; Incidence; Mortality; Pacemaker; Syncope; INTERDISCIPLINARY WORKING GROUP; AHA/ACCF SCIENTIFIC STATEMENT; HEART-ASSOCIATION COUNCILS; AMERICAN-AUTONOMIC-SOCIETY; OF-CARDIOLOGY-FOUNDATION; ORTHOSTATIC HYPOTENSION; CARDIOVASCULAR-DISEASE; OUTCOMES RESEARCH; CLINICAL CARDIOLOGY; RHYTHM-SOCIETY;
D O I
10.1016/j.amjmed.2008.08.024
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2009 Elsevier Inc. All rights reserved. . The American Journal of Medicine (2009) 122, 181-188
引用
收藏
页码:181 / 188
页数:8
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