Use of a Pediatric Syncope Unit Improves Diagnosis and Lowers Costs: A Hospital-Based Experience - 21/09/18
, Camilla Calvieri, MD, PhD 1, Silvia Placidi, MD 1, Daniela Righi, MD 1, Simone Paglia, CCP 1, Elisa Del Vecchio, PA, MA 1, Massimo Stefano Silvetti, MD 1, Fabrizio Gimigliano, MD 1, Corrado Di Mambro, MD 1, Marta Unolt, MD 1, Ugo Giordano, MD 2, Umberto Raucci, MD 3, Massimiliano Raponi, MD 4Abstract |
Objectives |
To assess the effect of a dedicated pediatric syncope unit on the diagnostic and therapeutic management of children with suspected syncope. We also evaluated the effectiveness of the pediatric syncope unit model in decreasing unnecessary tests and hospitalizations, minimizing social costs, and improving diagnostic yield.
Study design |
This single-center cohort observational, prospective study enrolled 2278 consecutive children referred to Bambino Gesù Children's Hospital from 2012 to 2017. Characteristics of the study population, number and type of admission examinations, and diagnostic findings before the pediatric syncope unit was implemented (2012-2013) and after the pediatric syncope unit was implemented (2014-2015 and 2016-2017) were compared.
Results |
The proportion of undefined syncope, number of unnecessary diagnostic tests performed, and number of hospital stay days decreased significantly (P < .0001), with an overall decrease in costs. A multivariable logistic regression analysis, adjusted for confounding variables (age, sex, number of diagnostic tests), the period after pediatric syncope unit (2016-2017) resulted as the best independent predictor of effectiveness for a defined diagnosis of syncope (P < .0001).
Conclusions |
Pediatric syncope unit organization with fast-tracking access more appropriate diagnostic tests is effective in terms of accuracy of diagnostic yield and reduction of costs.
Le texte complet de cet article est disponible en PDF.Keywords : syncope, diagnosis, therapeutic pathways, pediatric syncope unit
**Abbreviations : ED, GIMSI
Plan
| The authors declare no conflicts of interest. |
Vol 201
P. 184 - octobre 2018 Retour au numéro
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