Older age is associated with an increased risk of having a serious health episode shortly after an emergency department visit for an episode of fainting, or "syncope," according to study findings published in the Journal of the American Geriatrics Society.

Syncope, defined as the transient loss of consciousness, is a common reason for visits to the emergency department. While it is frequently not a cause for great concern, it may also indicate a potentially serious or life-threatening underlying illness, Dr. Benjamin C. Sun, of West Los Angeles Veterans Affairs Medical Center, and colleagues note. "The clinical evaluation of syncope is particularly challenging in older patients."

The researchers examined the association between age and serious events occurring within 2 weeks of an emergency department visit for syncope. Included in the study were 463 adult patients with syncope or near-syncope.

The treating physicians recorded the patients' risk factors, if any, for serious health events, and the patients completed a structured telephone interview 2 weeks later. Emergency department charts, hospital records, and telephone interview forms were reviewed by a three-physician panel to identify predefined events.

The team classified patients into age groups separated by 20 years. Patient ages ranged from 18 to 96 years, and 47 percent of subjects were at least 60 years of age.

Overall, 80 (17 percent) patients experienced a serious clinical event within 2 weeks. Four percent of subjects had a delayed diagnosis.

Frequent diagnoses included irregular heart beat, hemorrhage or anemia, stroke, structural heart disease and traumatic injuries.

Compared with patients between the ages of 18 and 39 years, the odds of having a serious health event were almost three-times greater for those between the ages of 40 and 59 years, and the risk was nearly four-times greater for patients who were 60 years of age or older. ,P> These findings suggest that patients with syncope who are older than 60 years have a fairly high risk of a serious adverse event within 2 weeks, and physicians should consider this when making a decision of whether to hospitalize these patients.