Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, USA.
Division of Cardiology, Department of Medicine, Minneapolis VA Healthcare System, Minneapolis, MN, USA.
J Cardiovasc Electrophysiol. 2018 Jun;29(6):916-922. doi: 10.1111/jce.13479. Epub 2018 Mar 22.
Syncope/collapse is a common reason for emergency department visits, and approximately 30-40% of these individuals are hospitalized. We examined changes in hospitalization rates, in-hospital mortality, and cost of syncope/collapse-related hospital care in the United States from 2004 to 2013.
We used the US Nationwide Inpatient Sample (NIS) from 2004 to 2013 to identify syncope/collapse-related hospitalizations using ICD-9, code 780.2, as the principal discharge diagnosis. Data are presented as mean ± SEM.
From 2004 to 2013, there was a 42% reduction in hospitalizations with a principal discharge diagnosis of syncope/collapse from 54,259 (national estimate 253,591) in 2004 to 31,427 (national estimate 156,820) in 2013 (P < 0.0001). The mean length of hospital stays decreased (2.88 ± 0.04 days in 2004 vs. 2.54 ± 0.02 in 2013; P < 0.0001), while in-hospital mortality did not change (0.28% in 2004 vs. 0.18% in 2013; P = 0.12). However, mean charges (inflation adjusted) for syncope/collapse-related hospitalization increased by 43.6% from $17,514 in 2004 to $25,160 in 2013 (P < 0.0001). The rates of implantation of permanent pacemakers and implantable cardioverter defibrillator remained low during these hospitalizations, and decreased over time (P for both < 0.0001).
Hospitalization rates for syncope/collapse have decreased significantly in the US from 2004 to 2013. Despite a modest reduction in length of stay, the cost of syncope/collapse-related hospital care has increased.
晕厥/昏倒 是急诊科就诊的常见原因，其中约 30-40%的患者需要住院治疗。我们研究了美国 2004 年至 2013 年晕厥/昏倒相关住院率、住院死亡率和住院费用的变化。
我们使用 2004 年至 2013 年美国全国住院患者样本（NIS），使用 ICD-9 代码 780.2 作为主要出院诊断，确定晕厥/昏倒相关住院患者。数据以平均值±标准误（SEM）表示。
2004 年至 2013 年，主要出院诊断为晕厥/昏倒的住院患者数量减少了 42%，从 2004 年的 54259 例（全国估计为 253591 例）减少到 2013 年的 31427 例（全国估计为 156820 例）（P<0.0001）。住院时间的平均值缩短（2004 年为 2.88±0.04 天，2013 年为 2.54±0.02 天；P<0.0001），而住院死亡率没有变化（2004 年为 0.28%，2013 年为 0.18%；P=0.12）。然而，晕厥/昏倒相关住院费用（经通胀调整后）平均增加了 43.6%，从 2004 年的 17514 美元增加到 2013 年的 25160 美元（P<0.0001）。在这些住院期间，永久性起搏器和植入式心脏复律除颤器的植入率仍然较低，并且随着时间的推移呈下降趋势（P 值均<0.0001）。
2004 年至 2013 年，美国晕厥/昏倒的住院率显著下降。尽管住院时间略有缩短，但与晕厥/昏倒相关的住院费用有所增加。
