Syncope: Outcomes and Conditions Associated with Hospitalization

SyncopeJoy

(Online supplemental material)

Parijat Saurav Joy MD, MPH. University of Iowa Hospitals and Clinics, Iowa City, IA

Gagan Kumar MD. Northeast Georgia Health System, Gainesville, GA

Brian Olshansky MD. University of Iowa Hospitals and Clinics. Iowa City, IA

Online only material

Tables: 4

Figures: 3

eTable 1. Demographic factors and comorbidities in patients with primary and secondary syncope.

eTable 2. New diagnoses, procedures and major outcomes in patients with primary and secondary syncope.

eTable 3. Yearly trend of new diagnoses and procedures in all primary syncope admissions.

eTable 4. Statistical comparison of outcomes of admissions for syncope from each admission

eFigure 1. Frequency of admissions with primary and secondary syncope diagnoses.

eFigure 2. Trend of mortality rate for primary and secondary syncope admissions versus frequency of admissions of individual patient.

eFigure 3. Yearly trend of inpatient mortality and hospital charges adjusted for inflation in single and multiple admissions for primary syncope (above) and secondary syncope (below).

eTable 1. Demographic factors and comorbidities in patients with primary and secondary syncope (Values are percentages).

Primary diagnosis of syncope / Secondary diagnosis of syncope / P value
Syncope/patient / 1 / 2-3 / 4-5 / >5 / P trend / Total (%) / 1 / 2-3 / 4-5 / >5 / P trend / Total (%)
Frequency (%) / 76.08 / 20.68 / 2.4 / 0.84 / 78.00 / 19.43 / 1.94 / 0.63
Age (years) / <.001 / 0.000 / <.001
18-34 / 3.08 / 1.59 / 1.39 / 5.91 / 3.05 / 4.30 / 1.94 / 2.13 / 6.95 / 4.27
35-49 / 8.63 / 4.99 / 5.61 / 13.50 / 8.19 / 9.41 / 5.63 / 7.75 / 13.89 / 9.07
50-64 / 20.72 / 13.35 / 12.33 / 20.39 / 19.31 / 20.05 / 14.42 / 14.46 / 25.04 / 19.13
65-79 / 31.68 / 30.45 / 26.67 / 20.65 / 30.93 / 31.01 / 30.78 / 26.11 / 18.27 / 30.43
80+ / 35.89 / 49.62 / 54.00 / 39.54 / 38.53 / 35.24 / 47.23 / 49.54 / 35.85 / 37.11
Males / 46.24 / 45.39 / 45.06 / 48.22 / 0.083 / 46.07 / 47.15 / 46.63 / 46.20 / 48.02 / 0.121 / 47.05 / <.001
Race / <.001 / 0.000 / <.001
White / 60.31 / 61.06 / 57.22 / 54.46 / 59.25 / 64.13 / 65.18 / 62.64 / 60.46 / 63.09
Black / 8.91 / 11.54 / 17.10 / 20.74 / 9.61 / 7.79 / 9.95 / 14.01 / 17.84 / 8.31
Hispanic / 14.83 / 13.19 / 11.68 / 15.71 / 15.29 / 14.47 / 12.60 / 12.07 / 14.58 / 15.06
Asian / 8.51 / 8.80 / 9.42 / 5.56 / 8.56 / 7.55 / 7.43 / 7.09 / 3.77 / 7.50
Native American / 0.04 / 0.07 / 0.00 / 0.00 / 0.04 / 0.04 / 0.07 / 0.00 / 0.00 / 0.05
other / 7.41 / 5.35 / 4.58 / 3.53 / 7.25 / 6.02 / 4.77 / 4.04 / 3.34 / 6.00
Insurance / <.001 / 0.000 / <.001
Private / 22.29 / 13.28 / 10.19 / 11.30 / 20.48 / 21.68 / 13.44 / 9.50 / 13.13 / 20.14
Medicare / 62.92 / 75.48 / 76.92 / 59.84 / 63.78 / 63.90 / 75.86 / 77.32 / 57.08 / 64.49
Medicaid / 8.67 / 8.36 / 10.22 / 17.83 / 9.53 / 8.43 / 7.59 / 9.86 / 19.48 / 9.18
Self / 2.72 / 1.13 / 1.24 / 7.15 / 2.82 / 2.79 / 1.24 / 1.16 / 5.49 / 2.92
Other / 3.41 / 1.74 / 1.43 / 3.88 / 3.4 / 3.20 / 1.88 / 2.16 / 4.81 / 3.27
Homeless / 0.17 / 0.16 / 0.21 / 0.91 / 0.005 / 0.18 / 0.21 / 0.23 / 0.00 / 1.18 / 0.001 / 0.24 / 0.001
Weekend / 27.81 / 27.19 / 27.70 / 25.95 / 0.037 / 27.79 / 25.12 / 24.18 / 23.71 / 23.58 / 0.000 / 24.96 / <.001
Comorbidities
s/p AICD / 1.28 / 2.31 / 3.25 / 4.77 / <.001 / 1.56 / 1.44 / 2.49 / 3.79 / 3.60 / 0.000 / 1.68 / 0.005
s/p PPM / 5.09 / 10.25 / 16.42 / 19.86 / <.001 / 6.43 / 4.47 / 8.47 / 14.21 / 17.15 / 0.000 / 5.4 / <.001
H/o SCD / 0.07 / 0.10 / 0.03 / 0.35 / 0.021 / 0.07 / 0.09 / 0.14 / 0.00 / 0.00 / 0.073 / 0.1 / 0.014
CAD / 24.36 / 32.76 / 39.28 / 35.39 / <.001 / 26.08 / 28.43 / 36.86 / 41.01 / 38.25 / 0.000 / 29.92 / <.001
HTN / 66.29 / 72.81 / 75.99 / 68.84 / <.001 / 67.45 / 62.93 / 69.50 / 71.92 / 66.30 / 0.000 / 63.87 / <.001
DM / 23.85 / 26.84 / 27.08 / 30.80 / <.001 / 24.51 / 24.96 / 28.08 / 26.75 / 29.16 / 0.000 / 25.51 / <.001
HLD / 35.94 / 37.29 / 38.69 / 32.83 / 0.001 / 35.89 / 34.00 / 36.83 / 36.28 / 32.08 / 0.000 / 34.19 / <.001
CHF / 8.95 / 12.58 / 14.62 / 12.36 / <.001 / 9.65 / 14.69 / 19.19 / 20.35 / 14.75 / 0.000 / 15.39 / <.001
Pulm. HTN / 0.04 / 0.09 / 0.09 / 0.00 / 0.034 / 0.05 / 0.11 / 0.18 / 0.25 / 0.26 / 0.000 / 0.12 / <.001
Aortic valve dis. / 2.97 / 4.01 / 4.77 / 2.21 / <.001 / 3.23 / 4.08 / 5.37 / 4.29 / 2.66 / 0.000 / 4.32 / <.001
BMI > 40 / 1.62 / 1.37 / 1.89 / 3.18 / 0.610 / 1.57 / 2.29 / 2.16 / 2.30 / 2.83 / 0.629 / 2.24 / <.001
Smoker / 17.33 / 15.48 / 13.69 / 16.50 / <.001 / 16.64 / 20.05 / 17.92 / 17.45 / 21.53 / 0.000 / 19.35 / <.001
COPD / 8.08 / 10.22 / 10.29 / 10.94 / <.001 / 8.38 / 11.08 / 13.30 / 14.29 / 14.15 / 0.000 / 11.33 / <.001
ILD / 1.01 / 1.18 / 1.05 / 1.15 / 0.043 / 1.02 / 2.56 / 2.70 / 2.16 / 2.83 / 0.548 / 2.56 / <.001
VTE / 0.51 / 0.64 / 0.90 / 1.50 / <.001 / 0.54 / 1.89 / 1.91 / 1.83 / 2.32 / 0.628 / 1.89 / <.001
Cirrhosis / 1.05 / 0.97 / 0.81 / 0.88 / 0.083 / 1.02 / 2.03 / 1.66 / 1.83 / 0.00 / 0.000 / 1.97 / <.001
ESRD / 1.57 / 2.12 / 2.14 / 1.94 / <.001 / 1.71 / 2.31 / 2.91 / 2.30 / 2.06 / 0.000 / 2.44 / <.001
Solid CA / 2.60 / 2.33 / 1.86 / 2.29 / 0.001 / 2.47 / 4.43 / 3.85 / 2.96 / 1.72 / 0.000 / 4.2 / <.001
Metastatic CA / 1.02 / 0.77 / 0.68 / 0.88 / <.001 / 0.94 / 2.18 / 1.49 / 0.91 / 0.86 / 0.000 / 1.98 / <.001
Hemat. CA / 0.87 / 0.89 / 0.84 / 0.44 / 0.577 / 0.85 / 1.36 / 1.21 / 1.38 / 0.00 / 0.000 / 1.3 / <.001
Collagen VD / 0.60 / 0.57 / 0.53 / 0.26 / 0.211 / 0.58 / 0.67 / 0.68 / 0.94 / 2.32 / 0.000 / 0.67 / 0.001
Rheum. Dis. / 1.32 / 1.68 / 1.61 / 0.71 / 0.003 / 1.36 / 1.42 / 1.70 / 1.61 / 0.00 / 0.025 / 1.44 / 0.058
HIV / 0.12 / 0.13 / 0.37 / 0.35 / 0.002 / 0.14 / 0.32 / 0.32 / 0.47 / 0.00 / 0.700 / 0.32 / <.001
Neurol. imp. / 1.81 / 2.20 / 2.42 / 2.29 / <.001 / 3.77 / 4.25 / 4.82 / 4.98 / 3.69 / 0.000 / 5.49 / <.001
Dementia / 6.45 / 10.27 / 11.99 / 7.77 / <.001 / 7.24 / 6.12 / 9.08 / 11.94 / 6.78 / 0.000 / 6.7 / <.001
Stroke / 2.08 / 2.50 / 2.76 / 2.03 / <.001 / 2.16 / 4.91 / 5.13 / 5.95 / 6.43 / 0.000 / 4.94 / <.001
Malnutrition / 1.83 / 2.28 / 2.20 / 2.38 / <.001 / 1.9 / 4.31 / 5.01 / 4.54 / 3.09 / 0.000 / 4.37 / <.001
Chr. anemia / 5.61 / 7.25 / 7.68 / 7.41 / <.001 / 5.94 / 8.56 / 10.06 / 9.78 / 9.26 / 0.000 / 8.79 / <.001

s/p = status post; AICD = automatic implantable cardioverter defibrillator; PPM = permanent pacemaker; SCD = sudden cardiac death; CAD = coronary artery disease; HTN = hypertension; DM = diabetes mellitus; HLD = hyperlipidemia; CHF = congestive heart failure; BMI = body mass index; COPD = chronic obstructive pulmonary disease; ILD = interstitial lung disease; VTE = venous thromboembolic disease; ESRD = end stage renal disease; CA = cancer; Collagen VD = collagen vascular disease.

eTable 2. New diagnoses, procedures and major outcomes in patients with primary and secondary syncope.

Primary diagnosis of syncope / Secondary diagnosis of syncope / P value
Syncope/patient / 1 / 2-3 / 4-5 / >5 / P trend / Total / 1 / 2-3 / 4-5 / >5 / P trend / Total
Frequency (%) / 76.08 / 20.68 / 2.4 / 0.84 / 78.00 / 19.43 / 1.94 / 0.63
Inpatient new diagnoses (n)
Seizure / 52 / 15 / ≤ 10 / ≤ 10 / 0.371 / 73 / 183 / 44 / ≤ 10 / ≤ 10 / 0.894 / 238 / <.001
Stroke / 34 / 11 / ≤ 10 / ≤ 10 / 0.101 / 51 / 215 / 46 / ≤ 10 / ≤ 10 / 0.067 / 271 / <.001
TIA / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / 17 / 45 / ≤ 10 / 0 / 0 / 0.100 / 54 / 0.002
SAH / 0 / 0 / 0 / 0 / 0 / ≤ 10 / ≤ 10 / 0 / 0 / 0.574 / ≤ 10
SDH / 0 / 0 / 0 / 0 / 0 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / 0.095 / 13 / 0.002
Atrial fib. / 153 / 60 / ≤ 10 / ≤ 10 / 0.017 / 227 / 853 / 203 / 24 / ≤ 10 / 0.355 / 1,123 / <.001
Ventricular fib / 12 / ≤ 10 / 0 / 0 / 14 / 101 / 19 / ≤ 10 / ≤ 10 / 0.173 / 130 / <.001
Atrial flutter / 31 / <10 / 0 / 0 / 40 / 0 / 0 / 0 / 0 / 0.753 / 250 / <.001
Bradyarrhythmia / 69 / 28 / 0 / ≤ 10 / 0.510 / 98 / 292 / 72 / ≤ 10 / 0 / 0.351 / 370 / <.001
Ventricular tach. / 155 / 65 / ≤ 10 / ≤ 10 / 0.056 / 234 / 406 / 118 / ≤ 10 / ≤ 10 / 0.276 / 550 / <.001
PSVT / 37 / 20 / ≤ 10 / ≤ 10 / 0.167 / 61 / 121 / 23 / ≤ 10 / 0 / 0.116 / 152 / <.001
AVT / <10 / ≤ 10 / 0 / 0 / <10 / ≤ 10 / ≤ 10 / 0 / 0 / 0.239 / <10 / 0.228
HTN emergency / 19 / ≤ 10 / ≤ 10 / ≤ 10 / 0.182 / 26 / 32 / 11 / ≤ 10 / ≤ 10 / 0.177 / 46 / 0.306
STEMI / 14 / ≤ 10 / ≤ 10 / ≤ 10 / 0.894 / 19 / 91 / 22 / ≤ 10 / ≤ 10 / 0.650 / 124 / <.001
NSTEMI / 0 / 0 / 0 / 0 / 0 / ≤ 10 / 0 / 0 / 0 / 0.623 / ≤ 10 / 0.394
Pulm. Embolism / 11 / ≤ 10 / ≤ 10 / ≤ 10 / 20 / 87 / 20 / ≤ 10 / 0 / 0.330 / 111 / <.001
Tamponade / ≤ 10 / ≤ 10 / ≤ 10 / 0 / 0.131 / <10 / 58 / 14 / 0 / 0 / 0.343 / 74 / <.001
Pneumothorax / 16 / ≤ 10 / 0 / 0 / 19 / 130 / 42 / ≤ 10 / ≤ 10 / 0.329 / 188 / <.001
Orthostasis / 45 / 19 / ≤ 10 / ≤ 10 / 0.003 / 70 / 127 / 51 / ≤ 10 / ≤ 10 / 0.003 / 192 / <.001
Hypoxia / 43 / ≤ 10 / ≤ 10 / 0 / 56 / 270 / 60 / ≤ 10 / ≤ 10 / 0.402 / 348 / <.001
Hypoglycemia / ≤ 10 / 0 / 0 / 0 / <10 / 21 / ≤ 10 / 0 / 0 / 0.371 / 26 / 0.001
Hypokalemia / 255 / 60 / 13 / ≤ 10 / 0.293 / 343 / 1220 / 316 / 34 / 11 / 0.359 / 1,646 / <.001
Hyponatremia / 120 / 38 / ≤ 10 / 0 / 0.240 / 169 / 587 / 155 / 19 / ≤ 10 / 0.503 / 790 / <.001
Hyperkalemia / 72 / 31 / ≤ 10 / 0 / 0.317 / 111 / 367 / 85 / ≤ 10 / ≤ 10 / 0.447 / 468 / <.001
Hypernatremia / 15 / ≤ 10 / ≤ 10 / 0 / 24 / 182 / 34 / 0 / 0 / 0.007 / 222 / <.001
Dehydration / 116 / 43 / ≤ 10 / ≤ 10 / 0.124 / 170 / 326 / 82 / ≤ 10 / ≤ 10 / 0.891 / 432 / <.001
Procedures performed (n)
AICD / 172 / 84 / ≤ 10 / 0 / 0.011 / 272 / 1742 / 632 / 49 / ≤ 10 / <.001 / 2,524 / <.001
Pacemaker / 450 / 189 / 15 / ≤ 10 / <.001 / 679 / 7808 / 1933 / 160 / 32 / 0.002 / 10,234 / <.001
BiV pacemaker / 29 / 15 / ≤ 10 / 0 / 0.231 / 46 / 353 / 111 / 13 / 0 / 0.134 / 491 / <.001
Afib ablation / 39 / 19 / ≤ 10 / ≤ 10 / <.001 / 66 / 581 / 220 / 10 / ≤ 10 / 0.001 / 852 / <.001
Cardioversion / 159 / 46 / ≤ 10 / ≤ 10 / 0.672 / 222 / 1479 / 287 / 24 / ≤ 10 / <.001 / 1,872 / <.001
EP study / 593 / 363 / 54 / ≤ 10 / <.001 / 1,051 / 1293 / 529 / 51 / ≤ 10 / <.001 / 1,951 / <.001
Coronary angio. / 1735 / 560 / 49 / 18 / 0.054 / 2,457 / 6747 / 1816 / 165 / 57 / 0.028 / 9,227 / <.001
Cardiac stent / 122 / 43 / ≤ 10 / 0 / 0.971 / 171 / 1707 / 456 / 47 / ≤ 10 / 0.391 / 2,330 / <.001
Blood transfusion / 2142 / 631 / 83 / 25 / 0.003 / 2,983 / 12 / ≤ 10 / ≤ 10 / ≤ 10 / <.001 / 21,129 / <.001
Holter / 348 / 170 / 33 / ≤ 10 / <.001 / 580 / 291 / 103 / ≤ 10 / ≤ 10 / 0.004 / 413 / <.001
EEG / 1921 / 605 / 57 / 32 / 0.003 / 2,745 / 1791 / 511 / 59 / 22 / <.001 / 2,503 / <.001
Echocardiogram / 9043 / 2076 / 170 / 51 / <0.001 / 11,340 / 10758 / 2341 / 164 / 68 / <.001 / 13,331 / <.001
Outcomes (%)
CPR / 0.12 / 0.10 / 0.12 / 0.09 / 0.429 / 0.11 / 0.57 / 0.41 / 0.30 / 0.34 / <.001 / 0.54 / <.001
Mechanical Vent / 0.20 / 0.14 / 0.06 / 0.00 / 0.005 / 0.19 / 1.70 / 1.14 / 0.78 / 1.03 / <.001 / 1.61 / <.001
Mortality / 0.22 / 0.14 / 0.03 / 0.00 / <.001 / 0.2 / 1.60 / 0.90 / 0.42 / 0.09 / <.001 / 1.43 / <.001
Disposition / <.001 / <.001 / <.001
Home / 77.88 / 67.64 / 66.85 / 70.43 / 75.87 / 67.77 / 56.57 / 55.42 / 64.55 / <.001 / 65.94
Home health / 7.67 / 10.07 / 10.91 / 9.00 / 8.01 / 10.98 / 13.80 / 14.38 / 10.90 / 11.31
Nursing home / 11.65 / 19.98 / 19.38 / 15.62 / 13.31 / 19.43 / 27.98 / 27.92 / 19.40 / 20.90
Others / 2.80 / 2.31 / 2.85 / 4.94 / 2.81 / 1.81 / 1.65 / 2.28 / 5.15 / 2.25

*P value for trend.

TIA = transient ischemic attack; SAH = subarachnoid hemorrhage; SDH = subdural hemorrhage; Atrial fib = atrial fibrillation; PSVT = paroxysmal supraventricular tachycardia; AVT = atrioventricular tachycardia; NSTEMI = non ST segment elevation myocardial infarction; HTN = hypertension; AICD = automatic implantable cardioverter defibrillator; BiV = biventricular; EP = electrophysiological; EEG = electroencephalogram; CPR = cardio-pulmonary resuscitation

eTable 3. Yearly trend of new diagnoses and procedures in all primary syncope admissions.

2005 / 2006 / 2007 / 2008 / 2009 / 2010 / 2011 / P *
Single admit (%) / 76.6 / 75.3 / 74.9 / 75 / 75 / 77 / 79 / 0.054
Inpatient new diagnoses (n)
Seizure / 19 / ≤ 10 / 18 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / <.001
Stroke / ≤ 10 / ≤ 10 / ≤ 10 / 15 / 11 / ≤ 10 / ≤ 10 / >.999
TIA / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / <.001
SAH / 0 / 0 / 0 / 0 / 0 / 0 / 0
SDH / 0 / 0 / 0 / 0 / 0 / 0 / 0
Atrial fib. / 35 / 22 / 39 / 35 / 29 / 35 / 32 / >.999
Ventricular fib / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
Atrial flutter / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / 12 / ≤ 10 / >.999
Bradyarrhythmia / 8 / 14 / 15 / 10 / 17 / 19 / 18 / 0.108
Ventricular tach. / ≤ 10 / ≤ 10 / ≤ 10 / 58 / 49 / 59 / 44 / <.001
PSVT / ≤ 10 / ≤ 10 / ≤ 10 / 15 / 17 / 13 / ≤ 10 / <.001
AVT / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / .999
HTN emergency / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
STEMI / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
NSTEMI / 0 / 0 / 0 / 0 / 0 / 0 / 0
Pulm. Embolism / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
Tamponade / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
Pneumothorax / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
Orthostasis / ≤ 10 / ≤ 10 / ≤ 10 / 13 / 16 / 12 / ≤ 10 / 0.054
Hypoxia / 0 / ≤ 10 / ≤ 10 / 14 / 15 / 11 / ≤ 10 / 0.031
Hypoglycemia / 0 / ≤ 10 / 0 / ≤ 10 / ≤ 10 / 0 / ≤ 10
Hypokalemia / 25 / 24 / 24 / 72 / 66 / 71 / 61 / <.001
Hyponatremia / ≤ 10 / 21 / 18 / 25 / 23 / 30 / 42 / <.001
Hyperkalemia / ≤ 10 / ≤ 10 / ≤ 10 / 19 / 23 / 18 / 30 / <.001
Hypernatremia / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10
Dehydration / ≤ 10 / 43 / 42 / 27 / 17 / 18 / 14 / 0.013
Procedures performed (n)
AICD / 50 / 49 / 31 / 38 / 43 / 36 / 25 / 0.003
Pacemaker / 114 / 106 / 113 / 109 / 90 / 90 / 57 / <.001
BiV pacemaker / ≤ 10 / 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / ≤ 10 / 0.017
Afib ablation / ≤ 10 / 10 / ≤ 10 / 14 / 12 / ≤ 10 / ≤ 10 / 0.047
Cardioversion / 23 / 31 / 32 / 36 / 41 / 22 / 37 / 0.279
EP study / 180 / 182 / 173 / 134 / 146 / 127 / 109 / <.001
Coronary angio. / 337 / 359 / 347 / 385 / 337 / 368 / 324 / 0.325
Cardiac stent / 33 / 25 / 15 / 27 / 26 / 18 / 27 / 0.217
Blood transfusion / 337 / 372 / 458 / 513 / 443 / 453 / 407 / <.001
Holter / 68 / 62 / 82 / 98 / 91 / 95 / 84 / .001
EEG / 398 / 368 / 397 / 424 / 404 / 405 / 349 / 0.35
Echocardiogram / 1692 / 1651 / 1695 / 1655 / 1670 / 1842 / 1718 / .001

*P value for trend.

eTable 4. Statistical comparison of outcomes of admissions for syncope from each admission.

Single Admission
(n=245,105) / ≥4 Admissions
(n=9119) / P value
In Hospital Mortality / 1.03% / 0.19% / <.001
Length of Stay, median (IQR) / 2 (1-4) / 3 (2-5) / <.001
Total Charges, Median USD (IQR) / 26138
(15764 - 43310) / 26126
(15894 - 44221) / 0.176

eFigure 1. Frequency of admissions with primary and secondary syncope diagnoses.

eFigure2. Trend of mortality rate for primary and secondary syncope admissions versus frequency of admissions of individual patient.

eFigure 3. Yearly trend of inpatient mortality and hospital charges adjusted for inflation in single and multiple admissions for primary syncope (above) and secondary syncope (below).