{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:32:50Z","timestamp":1784241170553,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T00:00:00Z","timestamp":1535673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR001109"],"award-info":[{"award-number":["KL2TR001109"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp; Health"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Early diagnosis is critical in the management of patients with acute coronary syndrome (ACS), particularly ST\u2010elevation myocardial infarction (STEMI), because effective therapies are time\u2010dependent. Aims of this secondary analysis were to determine: (i) the prognostic value of symptoms for an ACS diagnosis in conjunction with electrocardiographic (ECG) and troponin results; and (ii) if any of 13 symptoms were associated with prehospital delay in those presenting to the emergency department (ED) with potential ACS. Patients receiving a cardiac evaluation in the ED were eligible for the study. Thirteen patient\u2010reported symptoms were assessed in triage. Prehospital delay time was calculated as the time from symptom onset until registration in the ED. A total of 1,064 patients were enrolled in five EDs. The sample was 62% male, 70% white, and had a mean age of 60.2 years. Of 474 participants diagnosed with ACS, 118 (25%) had STEMI; 251 (53%) had non\u2010ST elevation myocardial infarction (NSTEMI); and 105 (22%) had unstable angina. Sweating (OR\u2009=\u20091.42 CI [1.01, 2.00]) and shoulder pain (OR\u2009=\u20091.64 CI [1.13, 2.38]) added to the predictive value of an ACS diagnosis when combined with ECG and troponin results. Shortness of breath (OR\u2009=\u20090.71 CI [0.50, 1.00]) and unusual fatigue (OR\u2009=\u20090.60 CI [0.42, 0.84]) were predictive of a non\u2010ACS diagnosis. Sweating predicted shorter prehospital delay (HR\u2009=\u20091.35, CI [1.10, 1.67]); shortness of breath (HR\u2009=\u20090.73 CI [0.60, 0.89]) and unusual fatigue (HR\u2009=\u20090.72, CI [0.57, 0.90]) were associated with longer prehospital delay. Patient\u2010reported symptoms are significantly associated with ACS diagnoses and prehospital delay. Sweating and shoulder pain combined with ECG signs of ischemia may improve the timely detection of ACS in the ED.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nur.21902","type":"journal-article","created":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T09:58:25Z","timestamp":1535709505000},"page":"459-468","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Patient\u2010reported symptoms improve prediction of acute coronary syndrome in the emergency department"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5650-0464","authenticated-orcid":false,"given":"Jessica K.","family":"Z\u00e8gre\u2010Hemsey","sequence":"first","affiliation":[{"name":"School of Nursing University of North Carolina at Chapel Hill Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larisa A.","family":"Burke","sequence":"additional","affiliation":[{"name":"Office of Research Facilitation College of Nursing University of Illinois at Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holli A.","family":"DeVon","sequence":"additional","affiliation":[{"name":"College of Nursing Biobehavioral Health Sciences University of Illinois at Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,31]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Missing data","author":"Allison P. 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