Self-reported symptoms 8 weeks after discharge: A comparison of takotsubo syndrome and myocardial infarction

Wallström, Sara; Ulin, Kerstin; Ömerovic, Elmir; Ekman, Inger

doi:10.1016/j.ijcard.2016.09.052

Cited by 15 publications

(13 citation statements)

References 29 publications

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“…The proportion of non-cardiovascular causes for re-admission was also similar in the current study, 21 of 40 re-admissions had a non-cardiovascular main diagnosis. This indicates that health is affected after TS, which is in line with previous studies 24 25. There is a large potential for cost savings if the re-admission rate can be reduced, even if this means increasing the number of outpatient and primary care visits.…”

Section: Discussionsupporting

confidence: 88%

“…Follow-up programmes focusing the patient as a person with needs and abilities have proved efficient by, for example, reducing re-admissions to hospital in patients with severe chronic heart failure 30 31. Previous studies have also shown that patients with TS often have persisting symptoms, such as pain, fatigue and shortness of breath, for as long as 4 years after discharge24 25 32 and would, therefore, probably benefit from this kind of supportive follow-up programme.…”

Section: Discussionmentioning

confidence: 99%

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Cohort study of healthcare use, costs and diagnoses from onset to 6 months after discharge for takotsubo syndrome in Sweden

et al. 2019

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ObjectiveLittle is known about the economic impact of takotsubo syndrome (TS) for patients and the health system after initial discharge from hospital. Therefore, the aim of this study was to describe the healthcare resource use and calculate direct healthcare costs for TS, from hospitalisation to 6 months after discharge, and explore the distribution of costs between TS and other diagnoses among patients with TS.Method, participants and settingCohort study investigating direct healthcare costs from hospitalisation, open specialised outpatient and primary care. Healthcare resource use during 6 months after diagnosis with TS was collected for 58 consecutive patients from the Regional Patient Register. Incidence-based direct healthcare costs, in 2015 values, were calculated using diagnosis-related group weights and unit costs from national statistics on healthcare costs.ResultsThe mean length of hospital stay was 10.2 days, index 6.4 and re-admissions 3.8 days. The mean number of follow-up encounters per patient was 15.6, of which two-thirds was specialised outpatient and one-third was primary care. This resulted in an average cost of €10 360. Of this, costs of €8026 (77.5%) occurred during encounters for which at least one of the registered conditions was cardiovascular. Costs differed little according to background characteristics.ConclusionThis study shows that patients utilise hospital, specialised outpatient and primary care after discharge for TS. Most direct healthcare costs relate to cardiac diagnoses. Patients with TS would probably benefit from a supportive follow-up programme after discharge from hospital.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Cohort study of healthcare use, costs and diagnoses from onset to 6 months after discharge for takotsubo syndrome in Sweden

et al. 2019

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“…Patients with TS report similar residual symptoms such as fatigue, breathlessness and chest pain, as patients with CHD 8 weeks after the acute event and long-term follow-up after one year indicate a negative impact on psychological wellbeing. 9 , 10…”

Section: Introductionmentioning

confidence: 99%

“…7,8 Patients with TS report similar residual symptoms such as fatigue, breathlessness and chest pain, as patients with CHD 8 weeks after the acute event and long-term follow-up after one year indicate a negative impact on psychological wellbeing. 9,10 One qualitative interview study conducted in hospital, or shortly after discharge, described long-term stressful circumstances among the participants that may have contributed to the onset of TS when being exposed to an acute trigger. 11 Another study found that patients tried to handle their situation by avoiding stress after the acute event as they were afraid of the recurrence of TS.…”

Section: Introductionmentioning

confidence: 99%

Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study

Sundelin

Bergsten

Tornvall

et al. 2020

European Journal of Cardiovascular Nursing

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Background A relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients’ self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome. Aims The aim of this study was to describe stress before and after the onset of Takotsubo syndrome. Methods Twenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up. Results Self-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful. Conclusion Patients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.

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“…However, currently, there are no national or international guidelines for the management and treatment of TTS and the follow‐up care, which may have consequences for patients (2, 15). Existing research shows that patients have a worse physical and mental quality of life, more remaining symptoms after TTS, more serious complications and worse prognosis than has previously been described in the literature (2, 16–18). Research implies that the symptoms of TTS are major part of the illness experiences which affects the patients' health and well‐being (17), symptom remains a long time after discharge (18) and there is a need from the patients to talk about their experience with healthcare personnel.…”

Section: Introductionmentioning

confidence: 91%

Patients’ experiences when afflicted by takotsubo syndrome – is it time for guidelines?

Mäenpää

Ekstrand

Petersson

et al. 2020

Scandinavian Caring Sciences

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Background Takotsubo syndrome (TTS) is an acute and reversible type of heart failure that shares common features with acute coronary syndrome. It is usually caused by psychological or physical stress, but for a third, triggers cannot be identified. Patients also suffer from residual symptoms and decreased mental health in the recovery phase and may struggle to comprehend and manage everyday living. Aim To describe patients' experiences when afflicted by takotsubo syndrome, after discharge from hospital. Method An inductive explorative design using a qualitative approach with semi‐structured individual interviews. The text was analysed using qualitative content analysis according to Graneheim and Lundman. Result Ten women and one man afflicted by TTS were interviewed two to twelve months after discharge. Six sub‐categories were identified, and a main category emerged: The process from symptom onset and understanding to increased awareness and changes in life. The patients suffered from emotional reactions and they sought answers and understanding about the underlying causes. The disease led to changes in patients' daily lives as they were affected physically and psychologically. Spouses and/or bystanders had a positive supporting role, but the patients desired more support from the healthcare professionals such as an earlier appointment for follow‐up with a nurse. Conclusion Being afflicted by TTS can lead to changes in life conditions but these changes vary among patients. Becoming ill was associated to acute physical stress and prolonged psychological stress and they suffered from emotional reactions. The follow‐up care needs to improve as the patients need more guidance from healthcare professionals and earlier appointment for follow‐up with a nurse. A structured and multiprofessional treatment with a person‐centred approach could support patients in their recovery.

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Self-reported symptoms 8 weeks after discharge: A comparison of takotsubo syndrome and myocardial infarction

Cited by 15 publications

References 29 publications

Cohort study of healthcare use, costs and diagnoses from onset to 6 months after discharge for takotsubo syndrome in Sweden

Cohort study of healthcare use, costs and diagnoses from onset to 6 months after discharge for takotsubo syndrome in Sweden

Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study

Patients’ experiences when afflicted by takotsubo syndrome – is it time for guidelines?

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