Association of Symptoms and Mode of Transportation to Emergency Department in Patients With Acute Coronary Syndrome
Key result
Classic ACS combined with pain and stress symptoms is linked to ~290% higher EMS use.
- AOR 3.90
- P=0.012
- n=278
Why the study?
It was unknown whether presenting symptom clusters are associated with EMS use in ACS patients and whether EMS use or symptom clusters relate to prehospital delay.
Are presenting symptom clusters associated with emergency medical services (EMS) use and prehospital delay in patients with acute coronary syndrome?
Population
3522 subjects with a history of or at risk for ACS across 5 sites in the United States, Australia, and New Zealand
Comparison
Presenting symptom clusters compared with classic ACS symptoms alone
Design
Secondary analysis of a randomized clinical trial
Follow-up
2-year
Authors
Discussion
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Member takes
Implication
Symptom clusters may promote EMS use to shorten ACS delay; leaves open need for prospective trials before practice change.
Study Design
Type
RCT (n=278)
Randomization
Randomized to usual care or an educational intervention
Multicenter
Yes
Structured PICO
Are presenting symptom clusters associated with emergency medical services (EMS) use and prehospital delay in patients with acute coronary syndrome?
P
Population
278 patients with a history of or at risk for acute coronary syndrome (ACS) who sought care for ACS during follow-up and had transportation mode documented, from 5 sites in the United States, Australia, and New Zealand.
I
Intervention
Presentation with classic ACS symptoms combined with pain and/or stress symptoms
C
Comparator
Presentation with classic ACS symptoms alone
O
Outcome
Emergency medical services (EMS) use and prehospital delay time
Main Result
Effect estimate: AOR 3.90
p-value: p=0.012
Patients experiencing classic ACS symptoms combined with other symptom clusters are more likely to use EMS, which significantly reduces prehospital delay.
Cite This Study
Davis et al. (2023) conducted an RCT in Acute Coronary Syndrome (n=278). Classic ACS plus both pain and stress symptoms vs. Classic ACS symptoms alone was evaluated on Emergency medical services (EMS) use (AOR 3.90, p=0.012). Classic ACS combined with pain and stress symptoms was associated with higher EMS use versus classic ACS alone (AOR 3.90; P=0.012), and EMS use reduced median prehospital delay by 68.5 minutes.