Highlights
- •This is the first study to reveal differences in the approach to the diagnosis of patients admitted with syncope to Internal Medicine Departments and their effect on mortality.
- •Despite large variations in the number of diagnostic tests performed between departments, the mortality is not affected.
- •This is a further proof that a cost-effective personalized approach does not affect short term outcomes of patients hospitalized with syncope.
Abstract
Most data on mortality and investigational approaches to syncope comes from patients
presented to emergency departments (ED). The aim of this study is to report intermediate
term mortality in syncope patients admitted to Internal Medicine Departments and whether
different diagnostic approaches to syncope affect mortality.
Methods and results A single-center retrospective-observational study conducted at
the Tel Aviv "Sourasky" Medical Center. Data was collected from electronic medical
records (EMRs), from January 2010 to December 2020. We identified 24,021 patients,
using ICD-9-CM codes. Only 7967 syncope patients were admitted to Internal Medicine
Departments and evaluated. Logistic regression models were used to determine the effects
of diagnostic testing per patient in each department on 30-day mortality and readmission
rates. All-cause 30-day mortality rate was 4.1%. There was a significant difference
in the number of diagnostic tests performed per patient between the different departments,
without affecting 30-day mortality. The 30-day readmission rate was 11.4%, of which
4.4% were a result of syncope.
Conclusion Syncope patients admitted to Internal Medicine Departments show a 30-day
all-cause mortality rate of ∼4%. Despite the heterogeneity in the approach to the
diagnosis of syncope, mortality is not affected. This novel information about syncope
patients in large Internal Medicine Departments is further proof that the diagnosis
of syncope requires a logic, personalized approach that focuses on medical history
and a few tailored, diagnostic tests.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: May 20, 2022
Accepted:
May 12,
2022
Received in revised form:
May 2,
2022
Received:
February 2,
2022
Identification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
