Abstract 17264: Trends of Emergency Department Visits for Syncope/ Collapse in USA: Analysis of 2006-2013 National Emergency Department Sample database
Background: Syncope/collapse accounts for approximately 3% of total Emergency Department (ED) visits, and available published literature indicates that about 30-40% of these individuals are admitted to hospital. To ascertain whether these hospitalization rates remain current, this study examined USA national 2006-13 trends in ED visits and hospitalizations for syncope/collapse.
Methods: We used Nationwide Emergency Department Sample (NEDS) from 2006 through 2013 to identify syncope/collapse related ED visits using Clinical Classifications Software code 102 (includes ICD 9 codes 780.2) as the first-listed diagnosis. NEDS is the largest all-payer ED-based database with discharge data from 947 hospitals located in 30 States. NEDS includes a 20% stratified sample of U.S. hospital-based EDs, comprising nearly 134 million visits per year.
Results: From 2006 to 2013, there was a 21% increase in ED visits with a principal discharge diagnosis of syncope/collapse (990,497 vs. 1,199,890, p <0.001, Fig 1). Despite this increase in ED visits, the percentage of patients who were hospitalized decreased significantly from 24% in 2006 to 13% in 2013 (Figure 1; p <0.001).
Females presented more commonly to ED with syncope/collapse than males (58% vs. 42%, p <0.001). The majority of patients presenting to ED were in the 18-44 year age-group; however, among those ultimately admitted to hospital, most were over 85 years of age. Private insurance and Medicare were the largest payers, followed by Medicaid.
Conclusions: From 2006 to 2013, ED visits for syncope/collapse increased 21% in the US, but the percentage of these patients admitted to hospital after an ED visit decreased significantly. These observations may reflect the results of education designed to improve syncope/collapse risk stratification in US Emergency Departments and switch to observation status for many of these patients.
Figure 1: Total number of ED visits and admission to the same hospital, from 2006 to 2013
Author Disclosures: V. Anand: None. S. George: None. D. Benditt: None. W. Adkisson: None. S. Adabag: None.
- © 2016 by American Heart Association, Inc.