Study Objective:Patients with syncope are frequently admitted to the hospital,butwhetherthisimprovesoutcomeisunknown.Wetestedwhetherhospitalizationreducedmortalityinpatientswhopresentedtoemergencydepartments(EDs)withsyncope.Methods:Weconductedapropensityanalysisoftheoutcomesofpatients≥18yearsold presenting to EDs with a primary diagnosis of syncope in April 2004–March2013.Themodelused1:1nearest-neighbormatchingtopredictedadmissionusingage,sex,urbanresidence,householdincome,and14significantcomorbiditiesfrom4 administrative databases of the province of Alberta. The primary outcome wasdeath.Results:Therewere57,417EDpatientswithaprimarydiagnosisofsyncope;8864wereadmitted,and48,553weredischargedin<24hours.Admittedpatientswereolder(median76vs49years),male(53%vs45%),rural(23%vs18%),andhadlowerincome (median $58,599 vs $61,422); allP<0.001. All comorbidities were higherinadmittedpatients(meanCharlsonscores,1.9vs0.7;P<0.001).Thepropensity-matchedhospitalizedpatientshadhigher30-daymortality(3.5%vs1.0%)and1-yearmortality(14.1%vs8.6%);bothP<0.001.Mortalityinallpropensityquintileswashigherinthehospitalizedgroup(allP<0.001).Themostcommoncausesofdeathin 2719 patients included chronic ischemic heart disease, 14%; lung cancer, 7.1%;acutemyocardialinfarction,6.9%;stroke,3.7%;chronicobstructivepulmonarydis-ease,3.6%;dementia,2.6%;andheartfailure,2.5%.Conclusions:HospitaladmissiondidnotreduceearlyorlatemortalityinpatientswhopresentedtotheEDwithsyncope.Mortalityisassociatedwithcomorbiditie
Lack of benefit from hospitalization in patients with syncope: A propensity analysis / P. Kaul, D.T. Tran, R.K. Sandhu, M. Solbiati, G. Costantino, R.S. Sheldon. - In: JOURNAL OF THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS OPEN. - ISSN 2688-1152. - 1:5(2020 Oct), pp. 716-722. [10.1002/emp2.12229]
Lack of benefit from hospitalization in patients with syncope: A propensity analysis
M. Solbiati;G. Costantino;
2020
Abstract
Study Objective:Patients with syncope are frequently admitted to the hospital,butwhetherthisimprovesoutcomeisunknown.Wetestedwhetherhospitalizationreducedmortalityinpatientswhopresentedtoemergencydepartments(EDs)withsyncope.Methods:Weconductedapropensityanalysisoftheoutcomesofpatients≥18yearsold presenting to EDs with a primary diagnosis of syncope in April 2004–March2013.Themodelused1:1nearest-neighbormatchingtopredictedadmissionusingage,sex,urbanresidence,householdincome,and14significantcomorbiditiesfrom4 administrative databases of the province of Alberta. The primary outcome wasdeath.Results:Therewere57,417EDpatientswithaprimarydiagnosisofsyncope;8864wereadmitted,and48,553weredischargedin<24hours.Admittedpatientswereolder(median76vs49years),male(53%vs45%),rural(23%vs18%),andhadlowerincome (median $58,599 vs $61,422); allP<0.001. All comorbidities were higherinadmittedpatients(meanCharlsonscores,1.9vs0.7;P<0.001).Thepropensity-matchedhospitalizedpatientshadhigher30-daymortality(3.5%vs1.0%)and1-yearmortality(14.1%vs8.6%);bothP<0.001.Mortalityinallpropensityquintileswashigherinthehospitalizedgroup(allP<0.001).Themostcommoncausesofdeathin 2719 patients included chronic ischemic heart disease, 14%; lung cancer, 7.1%;acutemyocardialinfarction,6.9%;stroke,3.7%;chronicobstructivepulmonarydis-ease,3.6%;dementia,2.6%;andheartfailure,2.5%.Conclusions:HospitaladmissiondidnotreduceearlyorlatemortalityinpatientswhopresentedtotheEDwithsyncope.MortalityisassociatedwithcomorbiditieFile | Dimensione | Formato | |
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