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Article
Delays in seeking medical care in hospitalized patients with decompensated heart failure
Open Access Articles
  • Robert J. Goldberg, University of Massachusetts Medical School
  • Jordan H. Goldberg, University of Massachusetts Medical School
  • Sean Pruell, University of Massachusetts Medical School
  • Jorge L. Yarzebski, University of Massachusetts Medical School
  • Darleen M. Lessard, University of Massachusetts Medical School
  • Frederick A. Spencer, McMaster University
  • Joel M. Gore, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Cardiovascular Medicine
Date
3-11-2008
Document Type
Article
Subjects
Aged; Female; Heart Failure; Hospitalization; Humans; Male; Patient Acceptance of Health Care; Time Factors
Abstract
PURPOSE: The magnitude of, and factors associated with, prolonged delay in seeking medical care in patients with acute myocardial infarction has been well described. It is unknown, however, what the extent of, and factors associated with, prehospital delay are in patients hospitalized with acute heart failure. The purpose of this study was to examine patterns of prehospital delay, and factors associated with delay in seeking medical care, in patients hospitalized with acute heart failure at all 11 medical centers in the Worcester, Massachusetts metropolitan area. METHODS: The medical records of 2587 greater Worcester residents with decompensated heart failure who were hospitalized in 2000 were reviewed for the collection of information about prehospital delay and demographic and clinical factors associated with extent of delay. RESULTS: Information about acute symptom onset and duration of delay in seeking medical care was available in only 44% of the hospital charts of patients with heart failure. The average delay time was 13.3 hours, while the median was 2.0 hours. Male sex, multiple presenting symptoms, absence of a history of heart failure, and seeking medical care between midnight and 6:00 am were associated with prolonged prehospital delay. CONCLUSIONS: The results of this study in residents of a large New England metropolitan area suggest that patients hospitalized with acute heart failure exhibit considerable delays in seeking medical care. Several demographic and clinical characteristics were associated with prolonged delay. More research is needed to better understand the reasons why patients with this serious and increasingly prevalent clinical syndrome delay seeking medical care in a timely fashion.
Rights and Permissions
Citation: Am J Med. 2008 Mar;121(3):212-8. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
18328305
Citation Information
Robert J. Goldberg, Jordan H. Goldberg, Sean Pruell, Jorge L. Yarzebski, et al.. "Delays in seeking medical care in hospitalized patients with decompensated heart failure" Vol. 121 Iss. 3 (2008) ISSN: 1555-7162 (Electronic)
Available at: http://works.bepress.com/jorge_yarzebski/26/