Predictors of hospitalization in emergency department patients with syncope - Wagner, Patrick; Bucher, Heiner C.; Bucheli, Bruno; Battegay, Edouard; Martina, Benedict (European Journal of Internal Medicine, 2000)
Background: Up to 67% of emergency department (ED) patients with syncope are hospitalized. Methods: To identify predictors of hospitalization in ED patients with syncope we studied all 95 patients admitted to our medical ED with syncope during a 3-month period. Complete records and triage decisions were analyzed. A 2-year follow-up was performed to evaluate the quality of the decision. Results: The mean age of 43 outpatients was 53±24 years compared to 73±16 years for 52 inpatients (P<0.002). All patients with cardiac syncope (n=7) had in-hospital care. In addition to cardiac etiology of syncope (OR 1.16, 95% confidence interval (CI) 1.04-1.29) and age (OR 1.05, 95% CI 1.02-1.08), predictors of hospitalization in age-adjusted analysis were unexplained etiology of syncope (OR 10.6, 95% CI 1.23-14.29, P=0.03) and the need for assistance with everyday activities (OR 3.48, 95% CI 0.95-107.7, P=0.05). Follow-up data were obtained in 84% of outpatients and in 98% of inpatients 27 months (range 24-34 months) after their ED stay. Conclusion: Predictors of in-hospital care include age, cardiac syncope, and factors unrelated to the prognosis, such as unexplained etiology of syncope and the need for assistance with everyday activities. © 2000 Elsevier Science B.V.
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