title: Diagnostic patterns in the evaluation of patients presenting with syncope at the emergency or outpatient department.
abstract: OBJECTIVE
  Patterns of syncope evaluation vary widely among physicians and hospitals. The aim of this study was to assess current diagnostic patterns and medical costs in the evaluation of patients presenting with syncope at the emergency department (ED) or the outpatient department (OPD) of a referral hospital.
  
  
  METHODS
  This study included 171 consecutive patients with syncope, who visited the ED or OPD between January 2009 and July 2009.
  
  
  RESULTS
  The ED group had fewer episodes of syncope [2 (1-2) vs. 2 (1-5), p=0.014] and fewer prodromal symptoms (81.5% vs. 93.3%, p=0.018) than the OPD group. Diagnostic tests were more frequently performed in the ED group than in the OPD group (6.2±1.7 vs. 5.3±2.0; p=0.012). In addition, tests with low diagnostic yields were more frequently used in the ED group than in the OPD group. The total cost of syncope evaluation per patient was higher in the ED group than in the OPD group [823,000 (440,000-1,408,000) won vs. 420,000 (186,000-766,000) won, p<0.001].
  
  
  CONCLUSIONS
  There were some differences in the clinical characteristics of patients and diagnostic patterns in the evaluation of syncope between the ED and the OPD groups. Therefore, a selective diagnostic approach according to the presentation site is needed to improve diagnostic yields and to reduce the time and costs of evaluation of syncope.
authors.affiliation: Division of Cardiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: Gu Hyun
authors.initials: GH
authors.lastname: Kang
authors.forename: Ju Hyeon
authors.initials: JH
authors.lastname: Oh
authors.forename: June Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: On
authors.forename: Hyoung Gon
authors.initials: HG
authors.lastname: Song
authors.forename: Ik Joon
authors.initials: IJ
authors.lastname: Jo
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Bae
authors.forename: Tae Gun
authors.initials: TG
authors.lastname: Shin
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000175:diagnosis*