title: Symptom clusters in patients presenting to the emergency department with possible acute coronary syndrome differ by sex, age, and discharge diagnosis.
abstract: OBJECTIVE
  To identify classes of individuals presenting to the ED for suspected ACS who shared similar symptoms and clinical characteristics.
  
  
  BACKGROUND
  Describing symptom clusters in undiagnosed patients with suspected ACS is a novel and clinically relevant approach, reflecting real-world emergency department evaluation procedures.
  
  
  METHODS
  Symptoms were measured using a validated 13-item symptom checklist. Latent class analysis was used to describe symptom clusters.
  
  
  RESULTS
  The sample of 874 was 37% female with a mean age of 59.9 years. Four symptom classes were identified: Heavy Symptom Burden (Class 1), Chest Symptoms and Shortness of Breath (Class 2), Chest Symptoms Only (Class 3), and Weary (Class 4). Patients with ACS were more likely to cluster in Classes 2 and 3. Women and younger patients were more likely to group in Class 1.
  
  
  CONCLUSIONS
  Further research is needed to determine the value of symptom clusters in the ED triage and management of suspected ACS.
authors.affiliation: University of Arizona College of Nursing, 1305 N. Martin Ave., Tucson, AZ 85721-0203, USA. Electronic address: anner@email.arizona.edu.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Rosenfeld
authors.affiliation: University of Arizona College of Nursing, 1305 N. Martin Ave., Tucson, AZ 85721-0203, USA.
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Knight
authors.affiliation: University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., #748 MC 802 Chicago, IL 60612, USA.
authors.forename: Alana
authors.initials: A
authors.lastname: Steffen
authors.affiliation: University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., #748 MC 802 Chicago, IL 60612, USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Burke
authors.affiliation: Oregon Health & Science University, Department of Emergency Medicine, 3181 SW Sam Jackson Park Rd. Portland, OR 97239, USA.
authors.forename: Mohamud
authors.initials: M
authors.lastname: Daya
authors.affiliation: University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., #748 MC 802 Chicago, IL 60612, USA.
authors.forename: Holli A
authors.initials: HA
authors.lastname: DeVon
mesh_terms: D054058:Acute Coronary Syndrome / Q000145:classification / Q000175:diagnosis*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000209:etiology; D004636:Emergency Service, Hospital; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D014218:Triage
keywords: Acute coronary syndrome; Age; Diagnosis; Latent class analysis; Race; Sex; Symptom clusters