Abstract Body

Background and purpose

Telephone triage is fully integrated in urgent primary care in the Netherlands. The underlying triage protocols do not consider possible differences between men and women. We aim to evaluate sex-specific differences for acute-onset chest pain, a key symptom in which adequate triage is pivotal.

Methods

A retrospective cohort study of consecutive patients who contacted a regional, urgent primary care facility in Alkmaar, the Netherlands in 2017. We performed descriptive analyses on sex differences in patient and symptom characteristics, triage assessment and subsequent outcomes.

Results

A total of 1,804 patients were included, the median age was 54 years and 57.5% were female. Women more frequently reported centrally located chest pain (32.2% vs 27.7%), nausea (23.4% vs 15.7%) and radiating pain to the back or jaw(s) (9.5% vs 5.9% and 5.8% vs 2.5% respectively).

Cardiovascular comorbidities were less common among women (47.5% vs 54.3%). Triage urgencies were comparable between men and women, with comparable ambulance activation rates. However, women were more often visited at home (10.9% vs 7.4%). At follow-up, women less often had an underlying cardiovascular condition (21.1% vs 29.7%), including acute coronary syndrome (5.3% vs 8.5%), when compared to men.

Conclusion

There are considerable differences between women and men who contact urgent primary care with chest pain. Notably, women have different symptom presentation, fewer cardiovascular risk factors, and lower risk of an underlying cardiovascular condition compared to men. Despite being at lower risk, ambulance activation is comparable between women and men.