Analysis of emergency department visits for palpitations (from the National Hospital Ambulatory Medical Care Survey).
Palpitations is a common complaint in patients who visit the emergency department (ED), with causes ranging from benign to life threatening. We analyzed the ED component of the National Hospital Ambulatory Medical Care Survey for 2001 through 2010 for visits with a chief complaint of palpitations and calculated nationally representative weighted estimates for prevalence, demographic characteristics, and admission rates. ED and hospital discharge diagnoses were tabulated and categorized, and recursive partitioning was used to identify factors associated with admission. An estimated 684,000 visits had a primary reason for visit of "palpitations" representing a national prevalence of 5.8 per 1,000 ED visits (0.58%, 95% confidence interval 0.52 to 0.64). Women and non-Hispanic whites were responsible for most visits. A cardiac diagnosis made up 34% of all ED diagnoses. The overall admission rate was 24.6% (95% confidence interval 21.2 to 28.1), with higher rates seen in the Midwest and Northeast compared with the West. Survey-weighted recursive partitioning revealed several factors associated with admission including age >50 years, male gender, cardiac ED diagnosis, tachycardia, hypertension, and Medicare insurance. In conclusion, palpitations are responsible for a significant minority of ED visits and are associated with a cardiac diagnosis roughly 1/3 of the time. This was associated with a relatively high admission rate, although significant regional variation in these rates exists.
UCLA Emergency Medicine Center, School of Medicine, University of California, Los Angeles, Los Angeles, California. Electronic address: mprobst@gmail.com.
Marc A
MA
Probst
UCLA Emergency Medicine Center, School of Medicine, University of California, Los Angeles, Los Angeles, California.
William R
WR
Mower
Robert Wood Johnson Foundation Clinical Scholars Program, UCLA Emergency Medicine Center, School of Medicine, University of California, Los Angeles, Los Angeles, California.
Hemal K
HK
Kanzaria
UCLA Emergency Medicine Center, School of Medicine, University of California, Los Angeles, Los Angeles, California.
Jerome R
JR
Hoffman
UCLA Cardiac Arrhythmia Center, Department of Medicine, Ronald Reagan UCLA Medical Center, School of Medicine, University of California, Los Angeles, Los Angeles, California.
Eric F
EF
Buch
Department of Emergency Medicine, Oregon Health and Science University, Portland, Oregon.
Benjamin C
BC
Sun
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013610:Tachycardia / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult