Characteristics and Admission Patterns of Patients Presenting with Syncope to U.S. Emergency Departments, 1992–2000

OBJECTIVES: To describe the characteristics and admission patterns of patients with syncope presenting to U.S. emergency departments (EDs). METHODS: The ED portion of the National Hospital Ambulatory Medical Care Survey, 1992-2000, was analyzed. Nationally representative weighted estimates for incidence and admission rates were estimated and stratified by demographic variables. Presence of cardiovascular diagnoses on ED discharge was noted. RESULTS: Of the 865 million ED visits during the nine-year study period, an estimated 6.7 million (0.77%; 95% confidence interval 95% CI = 0.69% to 0.85%) were related to syncope. Higher incidences of ED visits for syncope were found in elder, female, and non-Hispanic patients compared with their reference groups. The overall admission rate was 32% (95% CI = 28% to 36%). Older, male, and white patients were admitted more frequently than their counterparts. Of patients older than 80 years of age, 58% (95% CI = 49% to 67%) were admitted. Associated cardiovascular International Classification of Diseases, Ninth Revision (ICD-9), codes for ischemic, structural, and arrhythmic heart disease were noted in 10% (95% CI = 8% to 13%) of patients, and 66% (95% CI = 56% to 76%) of these patients were admitted. CONCLUSIONS: Syncope is a frequent reason for ED visits and admissions. Elders and patients with associated cardiovascular diagnoses are frequently discharged, and admission practices appear to deviate from consensus panel guidelines.