Analysis of symptoms network in patients with acute type A aortic dissection and its implications in emergency triage
10.3761/j.issn.0254-1769.2025.09.008
- VernacularTitle:急性A型主动脉夹层患者症状网络分析及对预检分诊的启示
- Author:
Mei HE
1
;
Jie XIONG
1
;
Sufang HUANG
1
;
Fangfang LI
1
;
Jin LI
1
;
Lanlan REN
1
;
Min CHEN
1
Author Information
1. 430000 武汉市 华中科技大学同济医学院附属同济医院急诊科
- Publication Type:Journal Article
- Keywords:
Aortic Dissection;
Symptom Network;
Limb Blood Pressure;
Emergency Triage;
Nurse
- From:
Chinese Journal of Nursing
2025;60(9):1075-1079
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct a symptom network in patients with acute type A aortic dissection(ATAAD),so as to provide theoretical basis for the screening of dissection ATAAD during emergency pre-screening triage.Methods There were 433 patients diagnosed with ATAAD during 2019 to 2023 in an emergency department of a tertiary hospital in Wuhan.Their basic information and medical records were reviewed by self-designed data questionnaire.UCINET6.0 software was used to construct a symptom network,analyze the centrality index and determine the core symptoms.Symptom distribution of patients with positive and negative blood pressure in extremities was analyzed in the further.Results The most common symptoms in patients with type A aortic dissection were chest pain(77.37％),back pain(42.96％),and sweating(29.79％).In the symptom network,chest pain had the highest degree(rs=659).The closeness of chest pain,chest tightness,shortness of breath,back pain,nausea and vomiting,limb numbness and fatigue were same(rc=93.33).Fatigue has the highest betweenness(rb=13.69).Patients with positive limbs blood pressure mainly reported chest pain(70.17％),back pain(44.96％),and nausea and vomiting(19.33％),while those with negative limb blood pressure mainly reported chest pain(63.64％),back pain(63.64％),and orosphyalgia(39.40％).Orosphyalgia had the highest degree(rs=20).Conclusion The symptoms of ATAAD are complex and varied in patients.During triage,nurses should measure the limb blood pressure when patients complained chest pain alone or when combined with other hypoperfusion symptoms,such as back pain,chest tightness,sweating,near-death sensation,and shortness of breath.Aortic dissection cannot be ruled out in patients with negative blood pressure when they had chest pain,back pain or orosphyalgia.
