A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2024-08-06 DOI:10.1016/j.jpsychores.2024.111883

Guillaume Foldes-Busque , Clermont E. Dionne , Marie-Andrée Tremblay , Stéphane Turcotte , Richard P. Fleet , Patrick M. Archambault , Isabelle Denis

{"title":"A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients","authors":"Guillaume Foldes-Busque , Clermont E. Dionne , Marie-Andrée Tremblay , Stéphane Turcotte , Richard P. Fleet , Patrick M. Archambault , Isabelle Denis","doi":"10.1016/j.jpsychores.2024.111883","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>This study sought to describe the 2-year evolution of the intensity and frequency of noncardiac chest pain (NCCP), NCCP-related disability and health-related quality of life in a cohort of emergency department (ED) patients. It also aimed to identify and characterize subgroups of patients who share similar NCCP trajectories.</p></div><div><h3>Methods</h3><p>672 consecutive patients with NCCP were prospectively recruited in two EDs. NCCP, physical and mental health-related quality of life and pain-related impairment were assessed at baseline and 6 months, 1 year and 2 years after the index ED visit.</p></div><div><h3>Results</h3><p>Significant reductions in the intensity and frequency of NCCP and in NCCP-related disability were observed over time, with 58.1% of patients being considered NCCP-free at the 2-year follow-up. Four trajectories of NCCP intensity were identified through latent class growth mixture modelling: Worsening Trajectory (6.8%), Persistence Trajectory (20.5%), Limited Improvement Trajectory (13.1%) and Remission Trajectory (59.5%). Physical quality of life was significantly higher in the latter two trajectories at all assessment points. Patients in the Remission Trajectory reported a better mental quality of life and a greater decrease in NCCP-related disability over time than those in the other trajectories.</p></div><div><h3>Conclusions</h3><p>Over 40% of ED patients with NCCP experienced persistent biopsychosocial morbidity that warrants further clinical attention.</p></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"186 ","pages":"Article 111883"},"PeriodicalIF":3.5000,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022399924002952/pdfft?md5=25c09ebc6cdb315ca6bae1c2a51992b2&pid=1-s2.0-S0022399924002952-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Psychosomatic Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022399924002952","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

This study sought to describe the 2-year evolution of the intensity and frequency of noncardiac chest pain (NCCP), NCCP-related disability and health-related quality of life in a cohort of emergency department (ED) patients. It also aimed to identify and characterize subgroups of patients who share similar NCCP trajectories.

Methods

672 consecutive patients with NCCP were prospectively recruited in two EDs. NCCP, physical and mental health-related quality of life and pain-related impairment were assessed at baseline and 6 months, 1 year and 2 years after the index ED visit.

Results

Significant reductions in the intensity and frequency of NCCP and in NCCP-related disability were observed over time, with 58.1% of patients being considered NCCP-free at the 2-year follow-up. Four trajectories of NCCP intensity were identified through latent class growth mixture modelling: Worsening Trajectory (6.8%), Persistence Trajectory (20.5%), Limited Improvement Trajectory (13.1%) and Remission Trajectory (59.5%). Physical quality of life was significantly higher in the latter two trajectories at all assessment points. Patients in the Remission Trajectory reported a better mental quality of life and a greater decrease in NCCP-related disability over time than those in the other trajectories.

Conclusions

Over 40% of ED patients with NCCP experienced persistent biopsychosocial morbidity that warrants further clinical attention.

查看原文本刊更多论文

急诊科患者非心源性胸痛预后的前瞻性调查

本研究旨在描述一组急诊科（ED）患者两年来非心源性胸痛（NCCP）的强度和频率、NCCP 相关残疾以及健康相关生活质量的变化情况。该研究还旨在识别和描述具有相似 NCCP 轨迹的患者亚群。结果随着时间的推移，NCCP 的强度和频率以及与 NCCP 相关的致残率显著降低，58.1% 的患者在 2 年随访时无 NCCP。通过潜类增长混合建模，确定了 NCCP 强度的四种轨迹：恶化轨迹（6.8%）、持续轨迹（20.5%）、有限改善轨迹（13.1%）和缓解轨迹（59.5%）。后两种轨迹的患者在所有评估点的身体生活质量都明显较高。与其他轨迹的患者相比，缓解轨迹患者的精神生活质量更高，与 NCCP 相关的残疾程度随时间推移也有更大程度的下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.