Impact of Admission of Patients With Syncope in Non-Teaching Hospitals Versus Teaching Hospitals: A Nationwide Analysis.

absolute mortality gender comparison lenght of hospitalization near syncope prevention of syncope

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
May 2023
Historique:
received: 03 05 2023
accepted: 26 05 2023
medline: 28 6 2023
pubmed: 28 6 2023
entrez: 28 6 2023
Statut: epublish

Résumé

Syncope is a common condition affecting many individuals, and it remains uncertain whether admission to academic medical centers (AMCs) leads to better outcomes than non-AMCs. This study is aimed to investigate whether there is a difference in mortality, length of stay (LoS), and total hospital charges between patients admitted with syncope to AMCs and non-AMCs. This retrospective cohort study used the National Inpatient Database (NIS) to examine patients aged 18 years and older admitted with a primary diagnosis of syncope to AMCs and non-AMCs from 2016 to 2020. Univariate and multivariate logistic regression analyses were conducted, adjusting for confounders, to assess the primary outcome of all-cause in-hospital mortality and secondary outcomes, including hospital LoS and total cost of admission. Patient characteristics were also described. Of the 451,820 patients who met the inclusion criteria, 69.6% were admitted to AMCs and 30.4% to non-AMCs. Patient age was similar between the two groups (68 years in AMC versus 70 years in non-AMC; p < 0.001), as was sex distribution (52% female in AMC versus 53% in non-AMC; 48% male in AMC versus 47% in non-AMC; p < 0.002). Most patients in both groups were white, while the percentages of black and Hispanic patients were slightly higher in non-AMCs. The study found no difference in all-cause mortality between patients admitted to AMCs and non-AMCs (p = 0.33). However, LoS was marginally longer in AMC patients (2.6 days in AMC versus 2.4 days in the non-AMC group; p < 0.001), and the total cost was higher for AMCs by $3,526 per admission. The estimated total economic burden related to syncope was over 3 billion USD per year. This study suggests that the teaching status of hospitals did not significantly affect the mortality of patients admitted with syncope. However, it may have contributed to marginally longer hospital LoS and higher total hospital charges.

Identifiants

pubmed: 37378229
doi: 10.7759/cureus.39545
pmc: PMC10292031
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e39545

Informations de copyright

Copyright © 2023, Malik et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

JAMA Intern Med. 2015 Jun;175(6):1065-7
pubmed: 25894921
Am Heart J. 1984 May;107(5 Pt 1):997-1005
pubmed: 6720531
J Am Coll Cardiol. 2002 Jul 3;40(1):142-8
pubmed: 12103268
Am J Med. 2009 Feb;122(2):181-8
pubmed: 19100958
Eur Heart J. 2016 May 14;37(19):1493-8
pubmed: 26242712
Heart. 2002 Oct;88(4):363-7
pubmed: 12231593
Yonsei Med J. 2010 Jul;51(4):499-503
pubmed: 20499413
Med Clin North Am. 2016 Sep;100(5):1019-32
pubmed: 27542422
Eur Heart J. 2018 Jun 1;39(21):1883-1948
pubmed: 29562304
Am J Med. 2006 Dec;119(12):1088.e1-7
pubmed: 17145254
J Am Coll Cardiol. 2008 Apr 1;51(13):1277-82
pubmed: 18371559
Drugs Aging. 1993 May-Jun;3(3):238-45
pubmed: 8324299
JAMA. 2017 May 23;317(20):2105-2113
pubmed: 28535236
J Gerontol A Biol Sci Med Sci. 1996 May;51(3):M95-101
pubmed: 8630708
Liver Transpl. 2008 Sep;14(9):1347-56
pubmed: 18756487
JAMA Intern Med. 2018 Jan 1;178(1):39-47
pubmed: 29131899
Prog Cardiovasc Dis. 2013 Jan-Feb;55(4):370-5
pubmed: 23472773
South Med J. 2019 Mar;112(3):143-146
pubmed: 30830226
Ann Intern Med. 2022 Jun;175(6):783-794
pubmed: 35467933
J Health Econ. 1983 Mar;2(1):1-28
pubmed: 10310322
J Am Coll Cardiol. 2019 Nov 12;74(19):2410-2423
pubmed: 31699282
JAMA. 1990 Sep 19;264(11):1426-31
pubmed: 2391739
Heart Rhythm. 2017 Aug;14(8):e155-e217
pubmed: 28286247
Milbank Q. 2002;80(3):569-93, v
pubmed: 12233250
N Engl J Med. 2002 Sep 19;347(12):878-85
pubmed: 12239256
J Gerontol. 1989 Nov;44(6):M179-83
pubmed: 2681357
Am J Med. 1961 Mar;30:418-38
pubmed: 13783504
Am J Cardiol. 2005 Mar 1;95(5):668-71
pubmed: 15721118
Isr Med Assoc J. 2008 Feb;10(2):104-8
pubmed: 18432020
JACC Clin Electrophysiol. 2018 Feb;4(2):265-273
pubmed: 29749948
Milbank Q. 2021 Mar;99(1):273-327
pubmed: 33751662

Auteurs

Mushrin Malik (M)

Internal Medicine, St. Barnabas Hospital Health System, New York City, USA.

Garry Francis-Morel (G)

Internal Medicine, St. Barnabas Hospital Health System, New York City, USA.

Classifications MeSH