Hwang Seon Young
Department of Nursing, Chosun University, Dong-gu, Gwangju, Korea.
J Korean Acad Nurs. 2009 Dec;39(6):888-98. doi: 10.4040/jkan.2009.39.6.888.
This study was conducted to examine and compare clinical manifestations and predicting factors for treatment-seeking delay among patients <65 and > or = 65 yr with first-time acute coronary syndrome (ACS).
A total of 288 patients who were diagnosed with ACS were individually interviewed at C university hospital in G-city from November 2007 to December 2008.
Median pre-hospital delays for younger and older patients were 5 and 12 hr, respectively. Younger patients were more likely to be current smokers, heavy drinkers, obese, stressed, and have an unhealthy diet and family history, and to complain of chest pain, left shoulder and arm pain, perspiration, and nausea. Older patients were more likely to have hypertension and diabetes, and to complain syncope and dyspnea. Logistic regression analyses showed that after adjustment for age, gender and education, progressive onset of symptom and no attribution to cardiac problem significantly predicted pre-hospital delay >3 hr in both younger and older patients. Low perceived health status was a significant independent predictor in older patients only.
Health care providers should be concerned with different manifestations between younger and older adults, and educate people at risk for heart attack about symptoms and actions to get immediate help.
本研究旨在检查和比较年龄小于65岁和大于或等于65岁的首次急性冠状动脉综合征（ACS）患者的临床表现及寻求治疗延迟的预测因素。
2007年11月至2008年12月期间，在G市C大学医院对总共288例被诊断为ACS的患者进行了个体访谈。
年轻患者和老年患者的院前延迟中位数分别为5小时和12小时。年轻患者更有可能是当前吸烟者、酗酒者、肥胖、有压力、饮食不健康且有家族病史，并主诉胸痛、左肩和手臂疼痛、出汗和恶心。老年患者更有可能患有高血压和糖尿病，并主诉晕厥和呼吸困难。逻辑回归分析表明，在对年龄、性别和教育程度进行调整后，症状逐渐出现且不归因于心脏问题在年轻患者和老年患者中均显著预测院前延迟>3小时。仅在老年患者中，低感知健康状况是一个显著的独立预测因素。
医疗保健提供者应关注年轻人和老年人之间的不同表现，并对有心脏病发作风险的人进行有关症状及寻求立即帮助的行动的教育。
