606 Initial experience with a novel active fixation lv lead equipped with an exposed helix for crt device implantation

were adjusted using multivariable logistic regression and reported as odds ratio (OR) with 95% confidence intervals (CI). Over 4 years, 44521 syncope visits (mean age 54.2 years, 46.2% male) occurred; 3984 patients had 7-day revisits or readmission. Proportions admitted as IP varied from 9% to 43% among hospitals as did 7-day readmissions, from 3% to 29%. Patients at low volume non-teaching or non-urban EDs were more likely to be admitted as IP (OR 1.32; 95%CI: 1.09-1.60), and there was heterogeneity in IP admission within ED categories (rural range 9%28%, urban range 8%-21%). Readmission rates ranged 3%-29%, with low volume EDs more likely to have readmissions within 7-days, (OR 1.93, 1.78-2.09). IP admissions were independently predicted by increased age (1.03 per year; 95%CI: 1.02-1.05); increased ED length of stay (1.04 per hour; 95%CI: 1.03-1.05); performance of chest x-ray (CXR) (1.54; 95%CI: 1.27-1.86); and transport by ground ambulance (1.31; 95%CI: 1.07-1.60). Higher 7-day readmission were independently predicted by age (1.006 per year; 95%CI: 1.00-1.01); ED length of stay (1.02 per hour; 95%CI: 1.01-1.05); CXR (1.07; 95%CI: 1.01-1.13); hospital admission at index presentation (1.79; 95%CI: 1.38-2.33). CONCLUSIONS: There are very large variations in ED practice and in factors associated with hospitalization and readmission for syncope. These pose both challenges for health services planning, and opportunities for improvement in care delivery.