There is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome
Copyright © 2022 Elsevier Inc. All rights reserved..
AIMS: Test for an association between prehospital delay for symptoms suggestive of acute coronary syndrome (ACS), persistent symptoms, and healthcare utilization (HCU) 30-days and 6-months post hospital discharge.
BACKGROUND: Delayed treatment for ACS increases patient morbidity and mortality. Prehospital delay is the largest factor in delayed treatment for ACS.
METHODS: Secondary analysis of data collected from a multi-center prospective study. Included were 722 patients presenting to the Emergency Department (ED) with symptoms that triggered a cardiac evaluation. Symptoms and HCU were measured using the 13-item ACS Symptom Checklist and the Froelicher's Health Services Utilization Questionnaire-Revised instrument. Logistic regression models were used to examine hypothesized associations.
RESULTS: For patients with ACS (n = 325), longer prehospital delay was associated with fewer MD/NP visits (OR, 0.986) at 30 days. Longer prehospital delay was associated with higher odds of calling 911 for any reason (OR, 1.015), and calling 911 for chest related symptoms (OR, 1.016) 6 months following discharge. For non-ACS patients (n = 397), longer prehospital delay was associated with higher odds of experiencing chest pressure (OR, 1.009) and chest discomfort (OR, 1.008) at 30 days. At 6 months, longer prehospital delay was associated with higher odds of upper back pain (OR, 1.013), palpitations (OR 1.014), indigestion (OR, 1.010), and calls to the MD/NP for chest symptoms (OR, 1.014).
CONCLUSIONS: There were few associations between prehospital delay and HCU for patients evaluated for ACS in the ED. Associations between prolonged delay and persistent symptoms may lead to increased HCU for those without ACS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
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| Enthalten in: |
Applied nursing research : ANR - 65(2022) vom: 16. Juni, Seite 151588 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rountree, Lauren M [VerfasserIn] |
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| Links: |
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| Themen: |
Acute coronary syndrome |
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| Anmerkungen: |
Date Completed 19.05.2022 Date Revised 17.01.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.apnr.2022.151588 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Rountree, Lauren M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a There is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome |
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| 500 | |a Date Revised 17.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Inc. All rights reserved. | ||
| 520 | |a AIMS: Test for an association between prehospital delay for symptoms suggestive of acute coronary syndrome (ACS), persistent symptoms, and healthcare utilization (HCU) 30-days and 6-months post hospital discharge | ||
| 520 | |a BACKGROUND: Delayed treatment for ACS increases patient morbidity and mortality. Prehospital delay is the largest factor in delayed treatment for ACS | ||
| 520 | |a METHODS: Secondary analysis of data collected from a multi-center prospective study. Included were 722 patients presenting to the Emergency Department (ED) with symptoms that triggered a cardiac evaluation. Symptoms and HCU were measured using the 13-item ACS Symptom Checklist and the Froelicher's Health Services Utilization Questionnaire-Revised instrument. Logistic regression models were used to examine hypothesized associations | ||
| 520 | |a RESULTS: For patients with ACS (n = 325), longer prehospital delay was associated with fewer MD/NP visits (OR, 0.986) at 30 days. Longer prehospital delay was associated with higher odds of calling 911 for any reason (OR, 1.015), and calling 911 for chest related symptoms (OR, 1.016) 6 months following discharge. For non-ACS patients (n = 397), longer prehospital delay was associated with higher odds of experiencing chest pressure (OR, 1.009) and chest discomfort (OR, 1.008) at 30 days. At 6 months, longer prehospital delay was associated with higher odds of upper back pain (OR, 1.013), palpitations (OR 1.014), indigestion (OR, 1.010), and calls to the MD/NP for chest symptoms (OR, 1.014) | ||
| 520 | |a CONCLUSIONS: There were few associations between prehospital delay and HCU for patients evaluated for ACS in the ED. Associations between prolonged delay and persistent symptoms may lead to increased HCU for those without ACS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Acute coronary syndrome | |
| 650 | 4 | |a Healthcare utilization | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Prehospital delay | |
| 700 | 1 | |a Mirzaei, Sahereh |e verfasserin |4 aut | |
| 700 | 1 | |a Brecht, Mary-Lynn |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenfeld, Anne G |e verfasserin |4 aut | |
| 700 | 1 | |a Daya, Mohamud R |e verfasserin |4 aut | |
| 700 | 1 | |a Knight, Elizabeth |e verfasserin |4 aut | |
| 700 | 1 | |a Zègre-Hemsey, Jessica K |e verfasserin |4 aut | |
| 700 | 1 | |a Frisch, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Dunn, Susan L |e verfasserin |4 aut | |
| 700 | 1 | |a Birchfield, Jesse |e verfasserin |4 aut | |
| 700 | 1 | |a DeVon, Holli A |e verfasserin |4 aut | |
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