TRENDS IN HOSPITALIZATION, DIAGNOSTIC TESTING, AND READMISSION OF PATIENTS WITH SYNCOPE: AN ANALYSIS USING STATE INPATIENT AND EMERGENCY DEPARTMENT DATABASES

Background: Syncope accounts for 1% of US emergency department (ED) visits. Because the etiology of syncope is often benign, diagnostic testing for syncope can be low yield and routine hospitalization has not been shown to improve outcomes. Thus, professional society guidelines from cardiology and emergency medicine have advocated shifting priorities in the decision to hospitalize patients from a focus on determining the etiology of syncope to stratifying the need for hospitalization by patients’ cardiac risk. Changes in utilization and clinical outcomes as a result of this paradigm shifts are not known. Thus, our objective was to characterize longitudinal changes in hospitalization and readmission rates of patients presenting to the ED with syncope. Methods: Using linked State Inpatient and Emergency Department Databases from the Agency for Healthcare Research and Quality, we conducted a retrospective study of all ED visits in 12 geographically diverse states in 2009 and 2013. First, we calculated annual...