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Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients—Invited Commentary
James V. Quinn, MD, MS
Arch Intern Med. 2009;169(14):1305-1306.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Syncope is a common and expensive symptom. It results in 1% to 1.5% of all emergency department (ED) visits, with the annual cost of patients admitted in the United States estimated to be $2.5 billion.1-3 In most patients, the causes are benign and are aggressively investigated to find the few who may experience clinically significant morbidity or mortality. Despite aggressive investigation, only 50% of patients with syncope ever get a clear diagnosis. This uncertainty of risk and diagnosis leads to tremendous variability among those who are admitted, how they are evaluated, and associated costs. Academic centers in the United States report ED admission rates ranging from 55% to 85%. Other health care systems, including Kaiser Permanente, admit about 35% of patients with syncope, whereas some countries, like Australia (admission rate, <30%) and Canada (admission rate, <20%), admit very few patients with syncope without any real . . . [Full Text of this Article]
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