PMID- 11044686
OWN - NLM
STAT- MEDLINE
DCOM- 20001121
LR  - 20190921
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 19
IP  - 10
DP  - 2000 Oct
TI  - Treatment-seeking delays in heart failure patients.
PG  - 932-8
AB  - BACKGROUND: Patients having cardiac symptoms often delay for hours before seeking 
      treatment. Delay time is usually defined as the amount of time between the 
      patient's first awareness of symptoms and arrival at the hospital. Excessive 
      delays in seeking medical care for heart failure (HF) symptoms may influence 
      patient outcomes. However, the treatment-seeking patterns of HF patients are not 
      well understood. METHODS: We obtained data through a retrospective chart audit to 
      describe the treatment-seeking behaviors of 753 HF patients, at a Veterans 
      Administration facility, and to identify predictors of delay in seeking medical 
      care for HF symptoms. Using univariate and multivariate analyses, we assessed 
      relationships among delay time, presenting symptoms, and patient characteristics. 
      RESULTS: The mean delay time was 2.93 +/- 0.68 days. The most common symptoms on 
      admission were dyspnea (76%), edema (66%), fatigue (37%), and angina (25%). 
      Variables negatively affecting delay time included presence of dyspnea and edema 
      (odds ratio [OR], 2.10 and 1.82; confidence interval [CI], 1.38 to 3.19 and 1.17 
      to 2.82, respectively), care by a primary care physician (OR, 2.04; CI, 1.45 to 
      2.88), and higher New York Heart Association (NYHA) Class (OR, 1.96; CI, 1.47 to 
      2.61). Variables positively affecting delay time were the presence of chest pain 
      (OR, 0.42; CI, 0.29 to 0.62) and a history of previous admission for HF (OR, 
      0.42; CI, 0.28 to 0.62). CONCLUSIONS: Delays in seeking treatment for HF symptoms 
      are significantly high. This study supports the need for interventions that will 
      increase early symptom recognition and management on the part of patients and 
      their families.
FAU - Evangelista, L S
AU  - Evangelista LS
AD  - California State University, Los Angeles, Department of Nursing, Los Angeles, 
      California, USA. levengel@ucla.edu
FAU - Dracup, K
AU  - Dracup K
FAU - Doering, L V
AU  - Doering LV
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Heart Failure/diagnosis/*therapy
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Acceptance of Health Care
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2000/10/25 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/10/25 11:00
PHST- 2000/10/25 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/10/25 11:00 [entrez]
AID - S1053-2498(00)00186-8 [pii]
AID - 10.1016/s1053-2498(00)00186-8 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2000 Oct;19(10):932-8. doi: 
      10.1016/s1053-2498(00)00186-8.