New screening tool helps doctors decide severity of fainting

Researchers, including one of Indian origin, have developed a simple nine-question tool that could help doctors uncover the dangerous hidden conditions that cause some people to faint.

In most cases, syncope or fainting is benign, but it can sometimes be caused by serious health conditions, researchers from the Ottawa Hospital and the University of Ottawa in Canada said.

They created the Canadian Syncope Risk Score to help emergency doctors predict the risk of a patient experiencing an adverse event, such as potentially fatal irregular heart rhythm, heart attack and other cardiac events, gastrointestinal bleeding, and even death within a month after fainting. "Fainting is a big problem. We hope that this screening tool will make the process more consistent and improve the detection of serious conditions related to fainting," said Venkatesh Thiruganasambandamoorthy from University of Ottawa.

Researchers looked at 4,030 patients from six Canadian hospitals. Of the total patients, 147 experienced a serious event in the month following discharge. Researchers found eight factors that physicians can plug in to a screening tool. When combined, these factors give the patient's total risk of an adverse event, from very low to very high.

The factors included the presumed cause of fainting at the end of emergency department assessment and whether fainting was triggered by the patient being in a warm or crowded place, standing for a long time or experiencing intense fear, emotion or pain.

The other factors were a history of heart disease abnormal electrocardiogram measurements, high levels of troponin, a protein that indicates damage to the heart if detected in blood and abnormal blood pressure reading during the emergency visit.

Most patients admitted to hospital for fainting do not need to be there, and can spend four to seven hours in the emergency department before a decision is made to discharge them, researchers said. "If our tool can discharge low-risk patients quickly and safely, then I think we can reduce emergency room wait times and open up those resources to other patients," said Thiruganasambandamoorthy.

The study was published in the Canadian Medical Association Journal.