Sex differences in help-seeking behaviour among patients presenting with acute coronary syndrome
Notice bibliographique
Résumé
Abstract Background Acute coronary syndrome (ACS) is a leading global cause of morbidity and mortality. While door-to-balloon times have improved, delays from symptom onset (SO) to first medical contact (FMC) remain unchanged, likely due to complex patient behaviours. Furthermore, there may be sex-specific differences in how ACS symptoms are perceived and the subsequent help-seeking behaviour. Purpose To understand delays in seeking care for ACS, focusing on sex differences in symptom recognition, help-seeking behaviour, and reasons for delay. Methods A prospective survey at a single centre from June-August 2024 was conducted. All ACS patients were eligible for inclusion. Patients were excluded if unable to provide consent, did not speak English or did not have a clear SO time. Patients completed a survey assessing SO and FMC times, symptom perception, and reasons for delay. Chart review for medical history was completed. Results Of the 93 included patients, mean age was 65±13 years and 79% were male (M). Cardiac risk factors including hypertension (60%, 56% female (M) vs 59% M), diabetes (31%, 40% F vs 25% M), dyslipidemia (49%, 44% F vs 45% M) showed no significant sex-based differences. The median SO-FMC delay was 9.58 hours (IQR 2.02–27.82), with 9.87 hours and 8.48 hours (p=0.92) for females and males, respectively. While there were no significant sex differences in emergency medical services (EMS) use, patients that used EMS presented earlier (2.9 vs 12.75 hours, p=0.02). Only 6.45% (4% F vs 7% M, p=0.91) of patients presented within 1 hour and 30% (32% F vs 34% M, p=1.0) within 3 hours. Males were most likely to present within one hour (odds ratio=1.9, p=0.7) compared to females. Patients experienced a variety of symptoms such as chest/arm/jaw pain (40% F vs 37% M, p=1.0), nausea/vomiting (28% F vs 15% M, p=0.33), dizziness and syncope (20% F vs 15% M, p=0.62), shortness of breath (32% F vs 19% M, p=0.35), and feeling clammy and sweating (16% F vs 28% M, p=0.12). In study population, feeling clammy resulted in statistically significant earlier presentations (3.85 vs 17.58 hours, p=0.007). The most common reasons for delayed presentation were symptom misinterpretation as non-cardiac (34%, 56% F vs 27% M, p=0.016) and hesitation/denial (19%, 12% F vs 22% M, p=0.43). Other reasons included logistical barriers (15%, 12% F vs 16% M, p=0.8), and immediate symptom relief (4%, 0% F vs 6% M, p=0.5). In 27% of patients, there was no identifiable reason. Conclusions Significant SO-FMC delays persist in ACS patients. Sex-based differences exist in patient’s behaviour when presenting with ACS, with different symptoms prompting male and female patients to seek help. The most common reason for delay in females seems to be symptoms misinterpretation while denial is a major factor in male patients’ delays. Targeted education on sex-specific ACS symptom recognition may help reduce delays and improve timely medical care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».