Atrial fibrillation symptom clusters and associated clinical characteristics and outcomes: A cross-sectional secondary data analysis.
Megan Streur, Sarah J Ratcliffe, David Callans and 2 others
PMID 29786450WHAT IT FOUND
In adults with atrial fibrillation, a cluster of fatigue, breathlessness at rest, chest pain and dizziness was linked to nearly triple emergency department use and almost twice the hospitalization rate after adjustment.
The exercise symptom cluster did not remain significant.
Key findings
01The Weary symptom cluster remained associated with nearly triple emergency department use and almost twice the hospitalization rate after adjustment, while the Exertional cluster did not remain significant.
02The Exertional symptom cluster was present in 33% of participants, while the Weary symptom cluster was present in 3.7%.
03Women were more likely than men to report all Weary symptoms, and a greater proportion of women than men had all Exertional symptoms despite the sample being mostly male.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only looked at associations at one point in time, so it cannot show that the symptom clusters caused more emergency visits or hospitalizations. Patients reported their own hospitalizations and emergency visits, which may be inaccurate. Depression, anxiety and other psychological symptoms were not measured, so they could have influenced both symptoms and care use. The sample came from one center and was mostly Caucasian and male, so it may not fit all atrial fibrillation populations. The dates of ablation were not known, so timing of procedures could not be considered. The identified clusters did not match clusters from an earlier atrial fibrillation trial, so their stability is uncertain.
Declared interests
No author conflict of interest statement is included in the supplied text. The publication types list NIH extramural research support.
The easy way to misread this
Do not use these symptom clusters to predict or triage individual patients as if they were validated clinical tools. The analysis is cross-sectional, utilization was self-reported, and the Exertional cluster lost significance after adjustment, so it does not establish that any cluster caused hospital use.