MedWire News: Most patients with acute heart failure delay seeking medical care, researchers highlight.

Early identification and treatment of patients presenting with acute symptoms of decompensated heart failure is associated with better outcomes, the authors explain.

Robert Goldberg (University of Massachusetts Medical School, Worcester, USA) and colleagues therefore examined patterns of prehospital delay, and factors associated with delay in seeking medical care, in 2587 patients hospitalized with acute heart failure.

Information about acute symptom onset and duration of delay in seeking medical care was available in only 44% of the medical records of patients hospitalized with heart failure.

The average delay from the development of acute symptoms to seeking medical care was 13.3 hours, while the median was 2.0 hours. Among patients who reported experiencing subacute, nonspecific symptoms of heart failure, the mean and median delays were 234 and 108 hours, respectively.

Patients with prolonged prehospital delay were more likely to be younger, male, arrive in the emergency department by means other than by ambulance, be from an urban setting, heavier, to present with a lower heart rate at the time of hospital admission, to have multiple acute symptoms, and to not have been previously diagnosed with heart failure than patients with delays shorter than 2 hours.

Goldberg and co-workers conclude in The American Journal of Medicine: "The results of this study reinforce the need for the systematic collection of data about symptom-onset times in patients hospitalized with acute heart failure by medical care personnel.

"Failure to collect this information may affect physicians' decisions to administer certain treatment modalities."

They add: "Efforts remain needed to more systematically identify the reasons why patients delay seeking medical care in the setting of this serious clinical syndrome."

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