Abstract
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.
Highlights
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
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 heart failure (HF) (OR, 0.42; CI, 0.28 to 0.62)
Summary
Additional research is needed to better understand reasons for long delays in this patient population. The objective of the current study was to address this need. The specific aims of the study were to (1) describe delay times between symptom onset and hospital admission, (2) examine the influence of previous HF hospitalizations on delay times, (3) assess the most common symptoms on admission for HF decompensation, and (4) identify the predictors of treatment-seeking delays
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