Heart Patients With Depression Often Find ER Delays
MONDAY Feb. 28, 2011 -- A new study finds that heart attack patients with a history of depression are less likely than other heart attack patients to receive priority care at emergency departments.
Canadian researchers analyzed data on 6,874 heart attack patients admitted to 96 hospitals in the province of Ontario between April 2004 and March 2005. Of these patients, 680 had a history of depression recorded in their medical charts. Of those, 39 percent were assigned a low priority triage score in the emergency departments, compared with 32.7 percent of the other heart attack patients.
The heart attack patients with depression were also more likely to experience delays in diagnostic testing and care, the researchers also found.
"Interestingly, other components of the medical history, including the traditional cardiac risk factors of diabetes, smoking, hypercholesterolemia and hypertension, were not associated with triage score in the models; only depression affected the score," wrote Dr. Clare Atzema, of the Institute for Clinical Evaluative Sciences in Toronto, and colleagues.
This lower priority given to heart attack patients with depression may be due to emergency department staff assuming that the patients' symptoms are anxiety-related rather than due to a heart attack, the researchers said.
They noted that fewer than 10 percent of patients who arrive at emergency departments with chest pain, shortness or breath and other heart attack symptoms are actually having a heart attack. Therefore, staff look for other possible causes of the symptoms.
"We suspect that mistriage of these patients is not due to purposeful discrimination by emergency department staff, but rather that most emergency department staff are unaware of data that suggests a link between depression and coronary artery disease," the researchers wrote in a news release from the Canadian Medical Association Journal, which published the research.
Education of staff could solve this problem, they suggested.
The U.S. National Heart, Lung, and Blood Institute has more about heart attack.
Posted: February 2011