Symptom Clusters in Patients Who Ruled Out for Acute Coronary Syndrome: Age Matters

2.50
Hdl Handle:
http://hdl.handle.net/10755/303870
Category:
Full-text
Type:
Presentation
Title:
Symptom Clusters in Patients Who Ruled Out for Acute Coronary Syndrome: Age Matters
Author(s):
DeVon, Holli A.; Rosenfeld, Anne G.
Lead Author STTI Affiliation:
Non-member
Author Details:
Holli A. DeVon, PhD, RN, FAHA, hdevon1@uic.edu; Anne G. Rosenfeld, PhD, RN, FAAN, FAHA;
Abstract:

Session presented on: Thursday, July 25, 2013

Purpose: Patients with potential acute coronary syndrome (ACS) make a decision to present to the emergency department (ED) partially based on symptoms. Differentiating which patients have ACS and require cardiac evaluation presents a diagnostic conundrum. Empirically derived symptom profiles could assist in risk stratification. Therefore, the purpose of the study was to examine the influence of age on subgroups of patients with similar symptom clusters who presented to the ED with symptoms suggestive of ACS who subsequently ruled out.

Methods: A sample of 318 patients (148 women; 170 men) was recruited from 3 EDs in 3 US states. Symptom data were collected upon presentation using a reliable and valid 13-item symptom checklist. Latent class analysis was used to identify patient groups (latent classes) with similar symptom profiles.'Analysis of Variance (ANOVA)'was used to compare symptoms by age.

Results: Mean age was 57.6 ('15.6) years. The most frequently reported symptom was chest discomfort (69.4%). Analysis of symptoms resulted in a 3 class solution. Class 1 (n = 114) included 7 high probability symptoms including chest pressure, chest discomfort, shortness of breath, unusual fatigue, nausea, lightheadedness, and chest pain. Class 2 (n = 102) included 3 high probability symptoms, all in the chest including pressure, discomfort, and pain. Class 3 (n = 102) included 3 moderate probability symptoms; shortness of breath, unusual fatigue, and lightheadedness. Patients in class 3 were significantly older: 63.6 years vs. 54 years (class 1) and 55.7 years (class 2) (p<0.0167).

Conclusion: Patients who present to the ED with ACS-like symptoms and are ruled-out can be classified into symptom clusters which vary by age. Older patients may be vulnerable to poorer outcomes due to ambiguous symptom clusters. Further research is required to determine clinical implications.

Keywords:
symptom clusters; geriatrics; acute coronary syndrome
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleSymptom Clusters in Patients Who Ruled Out for Acute Coronary Syndrome: Age Mattersen
dc.contributor.authorDeVon, Holli A.en
dc.contributor.authorRosenfeld, Anne G.en
dc.contributor.departmentNon-memberen
dc.author.detailsHolli A. DeVon, PhD, RN, FAHA, hdevon1@uic.edu; Anne G. Rosenfeld, PhD, RN, FAAN, FAHA;en
dc.identifier.urihttp://hdl.handle.net/10755/303870-
dc.description.abstract<p>Session presented on: Thursday, July 25, 2013</p><b>Purpose: </b>Patients with potential acute coronary syndrome (ACS) make a decision to present to the emergency department (ED) partially based on symptoms. Differentiating which patients have ACS and require cardiac evaluation presents a diagnostic conundrum. Empirically derived symptom profiles could assist in risk stratification. Therefore, the purpose of the study was to examine the influence of age on subgroups of patients with similar symptom clusters who presented to the ED with symptoms suggestive of ACS who subsequently ruled out. <p><b>Methods: </b>A sample of 318 patients (148 women; 170 men) was recruited from 3 EDs in 3 US states. Symptom data were collected upon presentation using a reliable and valid 13-item symptom checklist. Latent class analysis was used to identify patient groups (latent classes) with similar symptom profiles.'Analysis of Variance (ANOVA)'was used to compare symptoms by age. <p><b>Results: </b>Mean age was 57.6 ('15.6) years. The most frequently reported symptom was chest discomfort (69.4%). Analysis of symptoms resulted in a 3 class solution. Class 1 (n = 114) included 7 high probability symptoms including chest pressure, chest discomfort, shortness of breath, unusual fatigue, nausea, lightheadedness, and chest pain. Class 2 (n = 102) included 3 high probability symptoms, all in the chest including pressure, discomfort, and pain. Class 3 (n = 102) included 3 moderate probability symptoms; shortness of breath, unusual fatigue, and lightheadedness. Patients in class 3 were significantly older: 63.6 years vs. 54 years (class 1) and 55.7 years (class 2) (p<0.0167). <p><b>Conclusion: </b>Patients who present to the ED with ACS-like symptoms and are ruled-out can be classified into symptom clusters which vary by age. Older patients may be vulnerable to poorer outcomes due to ambiguous symptom clusters. Further research is required to determine clinical implications.en
dc.subjectsymptom clustersen
dc.subjectgeriatricsen
dc.subjectacute coronary syndromeen
dc.date.available2013-10-22T20:24:49Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:24:49Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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