Key result
Applying the Canadian Syncope Risk Score in the ED was associated with 169 fewer inpatient admissions per 1000 patients and a cost-saving of $8255 per admitted patient compared to usual care.
Why the study?
To evaluate the Canadian Syncope Risk Score from an economic perspective in emergency department syncope patients, using very-low and low-risk categories as a threshold to avoid hospital admissions.
Does applying the Canadian Syncope Risk Score reduce hospital admissions and costs in syncope patients presenting to the ED compared to usual care?
Does applying the Canadian Syncope Risk Score reduce hospital admissions and costs in syncope patients presenting to the ED compared to usual care?
Effect estimate: 169 fewer admissions per 1000 patients; $8255 saved per admitted patient
Applying the Canadian Syncope Risk Score in the emergency department is a cost-effective strategy that reduces hospital admissions and healthcare costs for syncope patients.
May reduce ED admissions and costs in low-risk syncope; leaves open prospective safety and real-world validation.
OBJECTIVE: To evaluate the Canadian Syncope Risk Score (CSRS) in syncope patients presenting to the ED from an economic perspective, using very-low and low-risk patients (CSRS -3 to 0) as a threshold for avoiding hospital admissions. METHODS: A decision-analytic model, specifically a decision-tree, was developed to evaluate application of the CSRS. A hypothetical cohort of 1000 patients was modelled based on characteristics and outcome of patients enrolled in a clinical validation study performed alongside this evaluation. Several analytic based approaches were used to handle model outputs and uncertainties. RESULTS: For a cohort of 1000 patients, applying the CSRS was associated with 169 less inpatient admissions from the ED, when compared to usual care. There was also a cost-saving of $8255 per admitted patient, when the CSRS was applied, compared to usual care. Adopting the CSRS was the optimal approach in all scenario analyses and was robust to changes in model parameters. More than three-quarters (78.6%) of all model simulations showed that applying the CSRS is a cost-saving approach to managing syncope. There was high confidence in all results, with the approach using the CSRS reducing the costs and number of syncope-related hospital admissions. CONCLUSIONS: Compared to usual care, applying the CSRS appeared as a cost-effective strategy. This new evidence will help decision-makers choose cost-effective approaches for the management of patients presenting to the ED with syncope, as they search for efficient ways to maximise health gain from a finite budget.
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Brain et al. (2022) studied Syncope (n=1,000). Canadian Syncope Risk Score (CSRS) vs. Usual care was evaluated on Inpatient admissions from the ED and costs (169 fewer admissions per 1000 patients; $8255 saved per admitted patient). Applying the Canadian Syncope Risk Score in the ED was associated with 169 fewer inpatient admissions per 1000 patients and a cost-saving of $8255 per admitted patient compared to usual care.
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