Among people at ED for syncope, women have lower mortality, odds of admission vs. men
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Compared with men, women admitted to the ED with syncope had lower mortality, regardless of discharge status, and were less likely to be admitted to the hospital, according to findings published in JACC: Clinical Electrophysiology.
Researchers found that among patients who presented to the ED with syncope, 12.6% of women and 16.8% men were admitted to hospital (P < .001).
Moreover, women who presented with syncope were younger (median age for women, 52 years; median age for men, 55 years; P < .001), were less likely to arrive via ambulance (women, 48.4%; men, 51.7%; P < .001) and had fewer comorbidities (women, 67.9% with Charlson comorbidity score of 0; men, 61.8% with Charlson comorbidity score of 0; P < .001).
“The ED is an important point of care among patients with syncope,” Roopinder K. Sandhu, MD, MPH, cardiac electrophysiologist and associate professor in the division of cardiology at the University of Alberta, Canada, and colleagues wrote. “However, sex-based differences in the frequency of ED visits, subsequent admission to the hospital, and prognosis based on ED discharge status exist.”
In other findings, women had lower mortality rates regardless of discharge status. At 30 days, among those admitted, women had a mortality rate of 2.9% vs. 4.4% for men, and among those discharged, women had a mortality rate of 0.2% vs. 0.4% for men (P < .001 for both). At 1 year, among those admitted, women had a mortality rate of 12.6% vs. 16.1% for men, and among those discharged, women had a mortality rate of 2.4% vs. 3.7% for men (P < .001 for both).
After adjustment, men who presented to ED with syncope experienced a 1.4-fold greater risk for death at 1 year compared with women. This risk was unchanged regardless of discharge status, according to the study.
For this study, researchers assessed all adult patients who presented to the ED with a primary diagnosis of syncope between 2007 and 2015 in Alberta, Canada (n = 63,274; 54% women). All patients were followed up from their initial ED visit until either March 31, 2016 or death, whichever occurred first.
“These data suggest that ED physicians are appropriately identifying low-risk syncope patients, which prevents unnecessary admissions,” the researchers wrote. “Further research is needed to reduce unnecessary ED visits. These may include triage performed by health help lines, ambulance personnel and general practitioners, as well as increasing patient awareness of when to utilize acute care settings.” – by Scott Buzby
Disclosures: The authors report no relevant financial disclosures.
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