Doctors in England are missing
“subtle signs” of imminent heart attacks, according to new research which found
that around 16 per cent of people who die from them are admitted to hospital
for other reasons in the 28 days prior to their death.
Symptoms such as fainting, shortness of
breath and chest pain would have been evident up to a month before death in
some of these patients, the study by the Imperial College London found. “Doctors are very good at treating heart
attacks when they are the main cause of admission,” said lead author Dr Perviz
Asaria. “But we don’t do very well treating secondary heart attacks or at
picking up subtle signs which might point to a heart attack death in the near
future.” She added: “Unfortunately, in the four weeks following a hospital
stay, nearly as many heart attack deaths occur in people for whom heart attack
is not recorded as a primary cause, as occur after an admission for heart
attack.” Researchers looked at all 446,744 NHS hospitals stays in England
between 2006 and 2010, including the 135,950 patients who died after recorded
heart attacks.
A total 21,677 of those who died
were in hospital during the preceding four weeks for a reason not noted as a
heart attack symptom. Of the 135,950 patients who died from a heart attack,
around half died without a hospital admission in the prior four weeks, and
around half died within four weeks of having been in hospital. The study’s
co-author, Professor Majid Ezzati, said: “We cannot yet say why these signs are
being missed, which is why more detailed research must be conducted to make
recommendations for change.
“This might include updated
guidance for healthcare professionals, changes in clinical culture, or allowing
doctors more time to examine patients and look at their previous records. “What
we are now asking is, if symptoms are being missed where they could have been
discovered using the available information, how should care now be organized
and what changes need to be made to prevent unnecessary deaths.” The study was
published in The Lancet Public Health journal.
A spokesman for the Royal College
of Physicians said: “The treatment of heart attacks is one of the success
stories of modern medicine but this paper is an important reminder that there
are still areas where we can improve care.” Coronary heart disease kills around
73,000 people each year in the UK.
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