Sensitivity, Specificity, and Sex Differences in Symptoms of Acute Coronary Syndrome

2.50
Hdl Handle:
http://hdl.handle.net/10755/335097
Category:
Full-text
Type:
Presentation
Title:
Sensitivity, Specificity, and Sex Differences in Symptoms of Acute Coronary Syndrome
Other Titles:
Health Promotion for the Cardiac Patient
Author(s):
DeVon, Holli A.; Steffan, Alana; Rosenfeld, Anne G.; Daya, Mohamud
Lead Author STTI Affiliation:
Alpha Lambda
Author Details:
Holli A. DeVon, PhD, RN, FAHA, FAAN, hdevon1@uic.edu; Alana Steffan, PhD; Anne Rosenfeld, PhD, RN, FAHA, FAAN; Mohamud Daya, MD, MS
Abstract:
Session presented on Monday, July 28, 2014: Purpose: Clinical symptoms are part of the risk stratification approaches used in the emergency department (ED) to evaluate patients with suspected acute coronary syndrome (ACS). The purpose of this study was to determine the sensitivity, specificity, and predictive value of 13 symptoms for a diagnosis of ACS in women and men. Methods: The sample included 736 patients admitted to four EDs with symptoms suggestive of ACS. Symptoms were assessed with the 13-item validated ACS Symptom Checklist. Mixed-effects logistic regression models were used to estimate sensitivity, specificity, and predictive value of each symptom for a diagnosis of ACS, adjusting for age, obesity, stair climbing ability, and diabetes. Results: Patients were predominantly male (63%) and Caucasian (70.5%), with a mean age of 59.7 - 14.2 years. Chest pressure, chest discomfort, and chest pain demonstrated the highest sensitivity for ACS in both women (66%, 67%, and 66%) and men (63%, 69%, and 72%). Six symptoms were specific for a non-ACS diagnosis in both women and men. The predictive value of shoulder (OR = 2.06, 95% CI = 1.09-3.87) and arm pain (OR 2.27, 95% CI = 1.20-4.35) in women was nearly twice that of men (OR = 1.14, 95% CI = 0.69-1.87 and OR = 1.24, 95% CI = 0.76-2.02). Shortness of breath (OR = 0.44, 95% CI = 0.28-0.71) and unusual fatigue (OR = 0.62, CI = 0.40-0.99) predicted a non-ACS diagnosis in men. Conclusions: There were more similarities than differences in symptom predictors of ACS for women and men. Shortness of breath, arm pain, and shoulder pain may be key symptoms which add predictive value to an ACS diagnosis for women.
Keywords:
acute coronary syndrome; gender; symptoms
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014 ; 17-Nov-2014
Other Identifiers:
INRC14N03
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleSensitivity, Specificity, and Sex Differences in Symptoms of Acute Coronary Syndromeen
dc.title.alternativeHealth Promotion for the Cardiac Patienten
dc.contributor.authorDeVon, Holli A.en
dc.contributor.authorSteffan, Alanaen
dc.contributor.authorRosenfeld, Anne G.en
dc.contributor.authorDaya, Mohamuden
dc.contributor.departmentAlpha Lambdaen
dc.author.detailsHolli A. DeVon, PhD, RN, FAHA, FAAN, hdevon1@uic.edu; Alana Steffan, PhD; Anne Rosenfeld, PhD, RN, FAHA, FAAN; Mohamud Daya, MD, MSen
dc.identifier.urihttp://hdl.handle.net/10755/335097-
dc.description.abstractSession presented on Monday, July 28, 2014: Purpose: Clinical symptoms are part of the risk stratification approaches used in the emergency department (ED) to evaluate patients with suspected acute coronary syndrome (ACS). The purpose of this study was to determine the sensitivity, specificity, and predictive value of 13 symptoms for a diagnosis of ACS in women and men. Methods: The sample included 736 patients admitted to four EDs with symptoms suggestive of ACS. Symptoms were assessed with the 13-item validated ACS Symptom Checklist. Mixed-effects logistic regression models were used to estimate sensitivity, specificity, and predictive value of each symptom for a diagnosis of ACS, adjusting for age, obesity, stair climbing ability, and diabetes. Results: Patients were predominantly male (63%) and Caucasian (70.5%), with a mean age of 59.7 - 14.2 years. Chest pressure, chest discomfort, and chest pain demonstrated the highest sensitivity for ACS in both women (66%, 67%, and 66%) and men (63%, 69%, and 72%). Six symptoms were specific for a non-ACS diagnosis in both women and men. The predictive value of shoulder (OR = 2.06, 95% CI = 1.09-3.87) and arm pain (OR 2.27, 95% CI = 1.20-4.35) in women was nearly twice that of men (OR = 1.14, 95% CI = 0.69-1.87 and OR = 1.24, 95% CI = 0.76-2.02). Shortness of breath (OR = 0.44, 95% CI = 0.28-0.71) and unusual fatigue (OR = 0.62, CI = 0.40-0.99) predicted a non-ACS diagnosis in men. Conclusions: There were more similarities than differences in symptom predictors of ACS for women and men. Shortness of breath, arm pain, and shoulder pain may be key symptoms which add predictive value to an ACS diagnosis for women.en
dc.subjectacute coronary syndromeen
dc.subjectgenderen
dc.subjectsymptomsen
dc.date.available2014-11-17T13:44:08Z-
dc.date.issued2014-11-17-
dc.date.issued2014-11-17en
dc.date.accessioned2014-11-17T13:44:08Z-
dc.conference.date2014en
dc.conference.name25th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationHong Kongen
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen
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