| Sex and age differences in atypical chief complaints for acute decompensated heart failure in the emergency department |
Matthew L. Regan1
, Jason J. Bischof1,2
, Montika Bush1
, Anna E. Waller1
, Timothy F. Platts-Mills3
, Martin F. Casey1
, Michelle L. Meyer1
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1Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
2Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA
3Ophirex Inc, Corte Madera, CA, USA |
| Correspondence
Michelle L. Meyer Tel: (919) 966-6539, Fax: (919) 966-3049, Email: michelle_meyer@med.unc.edu |
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Received: March 31, 2024. Revised: May 4, 2024. Accepted: May 6, 2024. Published online: May 23, 2024. |
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| ABSTRACT |
Objective
About one million United States emergency department (ED) visits annually are due to acute decompensated heart failure (ADHF) symptoms. Characterizing the presentation of ED symptoms among ADHF patients may improve clinical care; however, sex and age differences in ED chief complaints have not been thoroughly investigated. In this paper, we describe differences in chief complaints and comorbid conditions for ED patients with ADHF diagnoses, stratified by sex and age.
Methods
We conducted a retrospective analysis of adults presenting to North Carolina EDs using the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), a statewide syndromic surveillance system, between 2010 and 2016, screening for patients with a diagnosis of ADHF. We evaluated frequencies of chief complaint categories for ED visits and comorbid conditions, stratified by sex and age, and computed standardized differences.
Results
The most common chief complaints were dyspnea (19.1%), chest pain (13.5%), and other respiratory complaints (13.4%). In the 18–44 years age group, women were more likely than men to report nausea/vomiting (6.7% vs. 4.1%) and headache (4.2% vs. 2.0%). In those 45–64 and ≥65 years, complaints were similar by sex. When stratified by age group alone, the 18–44 and 45–64 years age groups had more complaints of chest pain, whereas balance issues, weakness, and confusion were more common in the ≥65 years age group.
Conclusion
Differences in atypical ADHF symptoms were seen in in ED patients based on sex and age. Understanding the variation in ADHF symptoms among ED patients can facilitate the identification of ED patients with ADHF and improve management of ADHF-related symptoms. |
| Keywords:
Emergency departments; Heart failure chief complaints; Atypical heart failure presentation; Heart failure differences between age and sex |
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