There is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome.
Lauren M Rountree, Sahereh Mirzaei, Mary-Lynn Brecht and 8 others
PMID 35577486WHAT IT FOUND
Prehospital delay showed little association with persistent symptoms or healthcare use after ED evaluation for possible ACS.
Some small associations appeared in both groups, but they were weak.
Key findings
01Many patients reported persistent symptoms after hospital discharge, including those without confirmed ACS.
02In patients with confirmed ACS, prehospital delay was not associated with persistent symptoms at 30 days or 6 months.
03Overall, prehospital delay showed little association with post-discharge symptoms or healthcare utilization, and the few significant associations had very small odds ratios.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were originally collected for another purpose. Symptoms and healthcare utilization were self-reported. The study did not know whether follow-up visits were planned or unplanned or what happened at those visits. Nearly 1 in 3 patients were lost to follow-up for 6-month healthcare utilization data, and those remaining were older, more likely White/Caucasian, higher income, and more likely insured than those lost. Income data were missing for some participants, and sensitivity analyses showed differences in symptoms and utilization among those missing income. Data were collected before widespread use of high-sensitivity troponins. The study analyzed associations, not causal effects.
Declared interests
No conflict-of-interest statement is provided in the article text; the publication types list research support from N.I.H., extramural.
The easy way to misread this
Do not conclude that prehospital delay is harmless or that patients without confirmed ACS need no follow-up. The study found little association overall, but many patients still reported persistent symptoms, and the design was observational with self-reported outcomes and substantial loss to follow-up.