Warning Symptoms Are Associated With Survival From XXXX .

@entity1164 @entity1 @entity662 @entity1353 @entity299
Background: Survival after @entity1164 ( @entity1164 ) remains low, and tools for improved prediction of @entity1 at long-term risk for @entity1164 are lacking. Alternative short-term approaches aimed at preemptive risk stratification and prevention are needed. Objective: To assess characteristics of symptoms in the 4 weeks before @entity1164 and whether response to these symptoms is associated with better outcomes. Design: Ongoing prospective population-based study. Setting: Northwestern United States (2002 to 2012). @entity1 : Residents aged 35 to 65 years with @entity1164 . Measurement: Assessment of symptoms in the 4 weeks preceding @entity1164 and association with survival to hospital discharge. Results: Of 839 @entity1 with @entity1164 and comprehensive assessment of symptoms (mean age, 52.6 years [SD, 8]; 75% @entity1 ), 430 (51%) had warning symptoms (50% of @entity1 vs. 53% of @entity1 ; P  = 0.59), mainly @entity662 and @entity1353 . In most symptomatic @entity1 (93%), symptoms recurred within the 24 hours preceding @entity1164 . Only 81 @entity1 (19%) called emergency medical services (911) to report symptoms before @entity1164 ; these @entity1 were more likely to be @entity1 with a history of @entity299 (P  < 0.001) or continuous @entity662 (P  < 0.001). Survival when 911 was called in response to symptoms was 32.1% (95% CI, 21.8% to 42.4%) compared with 6.0% (CI, 3.5% to 8.5%) in those who did not call (P  < 0.001). Limitation: Potential for recall and response bias, symptom assessment not available in 24% of @entity1 , and missing data for some @entity1 and @entity1164 characteristics. Conclusion: Warning symptoms frequently occur before @entity1164 , but most are ignored. Emergent medical care was associated with survival in @entity1 with symptoms, so new approaches are needed for short-term prevention of @entity1164 . Primary Funding Source: National Heart, Lung, and Blood Institute.
