You'll Faint When You See the Bill

The most expensive tests for evaluating syncope usually don't influence diagnosis or management, and the least expensive — and most useful — test is underused.

Hospitalization for syncope is common and frustrating, especially in elders. Loss of consciousness can be caused by a wide range of conditions, many benign but some life-threatening. These investigators undertook a detailed medical records review of all 1920 patients aged ≥65 admitted to a single U.S. hospital who presented to the emergency department with syncope between 2002 and 2006 (mean age, 79; 8.5% with a prior admission for syncope). The investigators recorded how often various diagnostic tests were performed, calculated the cost of the tests, and determined how frequently the results affected diagnosis or management.

Electrocardiography, cardiac biomarker studies, and telemetry monitoring were each performed in at least 95% of patie…

Reviewing Author

Frederick A. Masoudi, MD, MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)