title: Incidence and mortality rates of syncope in the United States.
abstract: OBJECTIVE
  Syncope is a common cause of hospitalization in the US. The main objective of this study is to determine the incidence and mortality rates when patients are admitted with a principle diagnosis of syncope.
  
  
  METHODS
  An observational cross-sectional study included patients with the principle diagnosis of syncope identified from the National Inpatient Sample database for the years 2000-2005. Incidence rate of syncope was adjusted according to the US Census data. In-hospital mortality and its predictors were identified by a logistic regression analysis, and Cochran-Armitage test was used for trend analysis.
  
  
  RESULTS
  After data cleansing, 305,932 patients were included in the analysis. Adjusted incidence rate of syncope varied between 0.80 and 0.93 per 1000 person-years and was unchanged over the years included in the analysis. Overall mortality rate is 0.28%, a trend that has not changed over the years (P=0.07). The odds ratio (OR) of death increased with age, becoming more prominent after age 40 years. Hospital mortality is higher in men (OR 1.49; 95% confidence interval [CI], 1.30-1.71) and in patients with higher comorbidity index (OR 1.39; 95% CI, 1.20-1.62) for moderate, and (OR 4.14; 95% CI, 3.05-5.61) for severe comorbidity index. The median cost of hospitalization is $8579, which increased by 3- to 11-fold if patients had a cardiac pacemaker or implantable cardioverter-defibrillator.
  
  
  CONCLUSIONS
  Syncope remains a common cause of hospital admission. The hospital mortality rate for syncope is low. A better definition and a nationally implemented care path for syncope diagnosis could provide a substantial cost savings.
authors.affiliation: Neurological Institute-Autonomic Laboratory, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA. amer.alshekhlee@uhhospitals.org
authors.forename: Amer
authors.initials: A
authors.lastname: Alshekhlee
authors.forename: Win-Kuang
authors.initials: WK
authors.lastname: Shen
authors.forename: Judith
authors.initials: J
authors.lastname: Mackall
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Chelimsky
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D010138:Pacemaker, Artificial; D013575:Syncope / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D014481:United States / Q000453:epidemiology