Age Differences in the Chief Complaint Associated With a First Acute Myocardial Infarction and Patient's Care-Seeking Behavior - 29/08/20
, Jerry H. Gurwitz, MD a, b, c, Ruben Miozzo, MD, PhD d, Anthony Nunes, PhD c, Joel M. Gore, MD c, Darleen Lessard, MS c, Jorge Yarzebski, MD, MPH c, Edgard Granillo, MD c, Robert J. Goldberg, PhD a, cAbstract |
Background |
This study set out to describe age differences in patient's chief complaint related to a first myocardial infarction and how the “typicality” of patient's acute symptoms relates to extent of prehospital delay.
Methods |
The medical records of 2586 residents of central Massachusetts hospitalized at 11 greater Worcester medical centers with a first myocardial infarction on a biennial basis between 2001 and 2011 were reviewed.
Results |
The average age of the study population was 66.4 years, 39.6% were women, 40.2% were diagnosed with a ST-elevation myocardial infarction (STEMI), and 72.0 % presented with typical symptoms of myocardial infarction, namely acute chest pain or pressure. Patients were categorized into 5 age strata: >55 years (23%), 55-64 years (20%), 65-74 years (19%), 75-84 years (22%), and ≥85 years (16%). The lowest proportion (11%) of atypical symptoms of myocardial infarction was observed in patients <55 years, increasing to 17%, 28%, 40%, and 51% across the respective age groups. The most prevalent chief complaint reported at the time of hospitalization was chest pain, but the proportion of patients reporting this symptom decreased from the youngest (83%) to the oldest patient groups (45%). There was a slightly increased risk of prehospital delay across the different age groups (higher in the oldest old) in those who presented with atypical, rather than typical, symptoms of myocardial infarction.
Conclusions |
The present results provide insights to the presenting chief complaint of patients hospitalized with a first myocardial infarction according to age and the relation of symptom presentation to patient's care-seeking behavior.
Le texte complet de cet article est disponible en PDF.Keywords : Care-seeking behavior, Chief complaint, Myocardial infarction
Plan
| Funding: Grant support for this project was provided by the National Heart, Lung, and Blood Institute (RO1 HL35434). JMG, RJG, JY supported in part by funding from the National Heart, Lung and Blood Institute (U01HL105268). MT, JHG supported by grants from the National Institute on AGING (R33AG057806 and R01AG062630). |
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| Conflicts of Interst: None. |
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| Authorship: All authors had access to the data and a role in writing this manuscript. |
Vol 133 - N° 9
P. e501-e507 - septembre 2020 Retour au numéro
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