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    Delayed hospital presentation in acute decompensated heart failure: Clinical and patient reported factors

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    Authors
    Darling, Chad E.
    Saczynski, Jane S.
    McManus, David D.
    Lessard, Darleen M.
    Spencer, Frederick A.
    Goldberg, Robert J.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Medicine, Division of Cardiovascular Medicine
    Department of Quantitative Health Sciences
    Department of Emergency Medicine
    Department of Medicine, Division of Geriatric Medicine
    Document Type
    Journal Article
    Publication Date
    2013-07-01
    Keywords
    UMCCTS funding
    Cardiology
    Cardiovascular Diseases
    Health Services Administration
    Health Services Research
    
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    Link to Full Text
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706507/
    Abstract
    BACKGROUND: Patients with acute decompensated heart failure (ADHF) often wait a considerable amount of time before going to the hospital. Prior studies have examined the reasons why such delays may occur, but additional studies are needed to identify modifiable factors contributing to these delays. PURPOSE: To describe care-seeking delay times, factors associated with prolonged delay, and patient's thoughts and actions in adult men and women hospitalized with ADHF. METHODS: We surveyed 1271 patients hospitalized with ADHF at 8 urban medical centers between 2007 and 2010. RESULTS: The average age of our study population was 73 years, 47% were female, and 72% had prior heart failure. The median duration of pre-hospital delay prior to hospital presentation was 5.3 h. Patients who delayed longer than the median were older, more likely to have diabetes, peripheral edema, to have symptoms that began in the afternoon, and to have contacted their medical provider(s) about their symptoms. Prolonged care seekers were less likely to have attributed their symptoms to ADHF, less likely to want to have bothered their doctor or family, and were more likely to be concerned about missing work due to their illness (all p values < 0.05). CONCLUSIONS: Care-seeking delays are common among patients with ADHF. A variety of factors contribute to these delays, which in some cases may represent efforts to manage ADHF symptoms at home. More research is needed to better understand the detrimental effects of these delays and how best to encourage timely care-seeking behavior in the setting of ADHF.
    Source

    Darling C, Saczynski JS, McManus DD, Lessard D, Spencer FA, Goldberg RJ. Delayed hospital presentation in acute decompensated heart failure: clinical and patient reported factors. Heart Lung. 2013 Jul-Aug;42(4):281-6. doi: 10.1016/j.hrtlng.2013.01.007. Link to article on publisher's site

    DOI
    10.1016/j.hrtlng.2013.01.007
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46615
    PubMed ID
    23474108
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1016/j.hrtlng.2013.01.007
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    Population and Quantitative Health Sciences Publications
    UMass Center for Clinical and Translational Science Supported Publications
    Emergency Medicine Publications

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