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Can J Cardiol. 2017 Apr;33(4):456-462. doi: 10.1016/j.cjca.2016.11.005. Epub 2016 Nov 11.

Nationwide Trends in Syncope Hospitalizations and Outcomes From 2004 to 2014.

Author information

1
Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: rsandhu2@ualberta.ca.
2
Division of Cardiology, University of Calgary, Calgary, Alberta, Canada.
3
Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
4
Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

We examined the prevalence, comorbidity burden, and outcomes of patients who presented to acute care hospitals with a primary diagnosis of syncope over a 10-year period in Canada.

METHODS:

The Canadian Institute for Health Information Discharge Abstract Database (which contains detailed health information from all Canadian provinces and territories except Quebec) was used to identify hospitalizations of patients with a primary diagnosis of syncope (International Classification of Diseases-10th Revision code R55) 20 years of age or older in Canada from 2004 to 2014. Annual age- and sex-standardized hospital discharge rates were calculated. Logistic regression was used to examine patient factors associated with in-hospital mortality, 30-day readmission for any cause, and syncope.

RESULTS:

During the 10-year study period, 98,730 hospitalizations occurred for syncope. The age- and sex-standardized hospitalization rate was 0.54 per 1000 population and decreased over time (P < 0.0001). Most patients (63%) were low-risk (Charlson comorbidity index = 0), although the proportion of patients with a Charlson comorbidity index ≥ 3 increased over time. Less than 1% of patients died in-hospital; however, among patients discharged alive, 30-day readmission rates for syncope and any cause were 1.1% and 9.0%, respectively. In-hospital mortality increased with each decade in age (odd ratio, 1.63; 95% confidence interval, 1.48-1.79), was higher in men (odds ratio, 1.37; 95% confidence interval, 1.16-1.63), and in patients with greater comorbidity (P < .0001).

CONCLUSIONS:

The hospitalization rate for syncope is decreasing over time in Canada. Although the comorbidity burden of hospitalized patients is increasing, most syncope patients are low-risk. Future studies are needed to help understand how standardized diagnostic testing pathways and discharge planning might lead to more efficient and cost-effective syncope management.

PMID:
28129966
DOI:
10.1016/j.cjca.2016.11.005
[Indexed for MEDLINE]

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