Table 1.
Baseline characteristics of 993 (55.3%) female and 802 (44.7%) male patients contacting the OHS-PC with chest discomfort (pain, pressure, tightness or discomfort)
| Characteristics | 993 women | Difference (95% CI) | 802 men | Difference (95% CI) | P value interaction gender | ||||
| ACS | No ACS | P value | ACS | No ACS | P value | ||||
| n=85 (8.6%) | n=908 (91.4%) | n=120 (15.0%) | n=682 (85.0%) | ||||||
| Mean age in years (SD) | 73.6 (±14.1) | 57.8 (±20.1) | <0.001 | 15.8 (11.4 to 20.2) | 67.2 (±13.0) | 56.9 (±19.2) | <0.001 | 10.3 (6.7 to 13.9) | 0.094 |
| Call characteristics | |||||||||
| Call duration min mean (SD) | 6:47 (±5:16) | 7:47 (±3:48) | 0.021 | 1.00 (0.19 to 1.80) | 6:31 (±3:13) | 7:33 (±3:42) | 0.004 | 1.02 (0.37 to 1.68) | 0.803 |
| Patient’s introduction min mean (SD) | 0:14 (±0:08) | 0:19 (±0:13) | <0.001 | 0.05 (0.02 to 0.09) | 0:16 (±0:11) | 0:19 (±0:14) | 0.06 | 0.03 (0.00 to 0.06) | 0.042 |
| Triage nurse consulted the GP | 35 (41.2) | 483 (53.2) | 0.034 | 12.0 (0.3 to 22.9) | 64 (53.3) | 381 (55.9) | 0.607 | 2.5 (–7.3 to 12.6) | 0.208 |
| Someone else called on behalf of patient | 59 (69.4) | 433 (47.7) | <0.001 | 21.7 (10.1 to 31.6) | 79 (65.8) | 360 (52.8) | 0.008 | 13.0 (3.0 to 22.2) | 0.251 |
| The patient or person who called expressed concern (n=922) | 36 (97.3) | 409 (88.9) | 0.109 | 8.4 (–5.0 to 12.6) | 52 (96.3) | 321 (86.5) | 0.041 | 9.8 (–0.9 to 14.8) | 0.935 |
| Chest pain (n=1739) | 81 (98.8) | 817 (93.1) | 0.055 | 5.7 (–0.8 to 8.0) | 110 (92.4) | 624 (94.5) | 0.364 | 2.1 (–2.3 to 9.0) | 0.048 |
| Severe pain (>7 on a scale of 0–10) (n=753) | 17 (65.4) | 147 (38.1) | 0.006 | 27.3 (5.7 to 44.7) | 13 (23.6) | 87 (30.4) | 0.312 | 6.8 (–7.9 to 18.3) | 0.007 |
| Duration | |||||||||
| >15 min (n=1501) | 66 (100) | 729 (95.8) | 0.102 | 4.2 (–2.8 to 6.0) | 99 (97.1) | 541 (94.6) | 0.292 | 2.5 (–3.8 to 5.6) | 0.998 |
| <12 hours (n=1563) | 60 (85.7) | 575 (72.7) | 0.018 | 13.0 (1.7 to 20.6) | 88 (81.5) | 431 (72.6) | 0.052 | 8.9 (–0.6 to 16.5) | 0.49 |
| Location (n=1267)* | |||||||||
| Retrosternal | 33 (62.3) | 263 (40.3) | 0.002 | 22.0 (7.1 to 35.2) | 42 (52.5) | 191 (39.7) | 0.032 | 12.8 (0.5 to 24.8) | 0.323 |
| Right or left side thorax | 14 (26.4) | 260 (39.8) | 0.054 | 13.4 (–1.2 to 24.8) | 26 (32.5) | 211 (43.9) | 0.057 | 11.4 (–1.0 to 22.2) | 0.757 |
| Type of pain (n=1334)† | |||||||||
| Pressing/heavy/tightening | 44 (78.6) | 423 (61.5) | 0.011 | 17.1 (3.2 to 27.2) | 78 (82.1) | 284 (57.4) | <0.001 | 24.7 (14.3 to 32.9) | 0.368 |
| Stabbing | 8 (14.3) | 155 (22.5) | 0.152 | 8.2 (–4.6 to 16.4) | 8 (8.4) | 131 (26.5) | <0.001 | 18.1 (9.2 to 24.1) | 0.141 |
| Radiation of chest pain (n=1391)‡ | |||||||||
| Any location | 61 (85.9) | 485 (68.6) | 0.002 | 17.3 (6.0 to 25.0) | 65 (63.7) | 292 (57.1) | 0.218 | 6.6 (–4.5 to 16.7) | 0.071 |
| Arm | 31 (75.6) | 188 (45.9) | <0.001 | 29.7 (12.8 to 42.2) | 47 (56.0) | 117 (34.8) | <0.001 | 21.1 (8.7 to 32.9) | 0.339 |
| Between the shoulder blades | 11 (52.4) | 159 (41.7) | 0.336 | 10.7 (–12.0 to 32.5) | 14 (27.5) | 91 (29.4) | 0.781 | 1.9 (–13.4 to 14.3) | 0.352 |
| Jaws | 10 (50.0) | 66 (22.9) | 0.007 | 27.1 (4.3 to 49.7) | 1 (2.6) | 28 (11.3) | 0.098 | 8.7 (–4.6 to 14.1) | 0.015 |
| Shortness of breath (n=1365) | 47 (72.3) | 455 (66.3) | 0.328 | 6.0 (–7.2 to 16.7) | 53 (60.9) | 329 (62.4) | 0.788 | 1.5 (–9.5 to 13.3) | 0.355 |
| Symptoms similar to previous cardiac event (n=748) | 13 (32.5) | 79 (21.4) | 0.108 | 11.1 (–3.0 to 28.4) | 27 (52.9) | 92 (32.1) | 0.004 | 20.8 (5.4 to 35.8) | 0.532 |
| ANS-related symptoms | |||||||||
| Sweating (n=1130) | 28 (49.1) | 234 (42.5) | 0.34 | 6.6 (–7.4 to 20.7) | 43 (52.4) | 170 (38.5) | 0.015 | 13.9 (16.7 to 25.8) | 0.418 |
| Nausea or vomiting (n=808) | 16 (44.4) | 240 (56.2) | 0.173 | 11.8 (–6.2 to 28.6) | 27 (45.8) | 122 (42.7) | 0.661 | 3.1 (–11.1 to 17.7) | 0.186 |
| Pallor or ashen skin (n=652) | 20 (55.6) | 110 (35.5) | 0.019 | 20.1 (1.9 to 37.0) | 28 (53.8) | 103 (40.6) | 0.078 | 13.2 (–2.3 to 28.3) | 0.545 |
| Dizziness or near fainting n=1599) | 13 (18.6) | 197 (24.4) | 0.277 | 5.8 (–6.0 to 14.3) | 17 (15.9) | 127 (20.7) | 0.249 | 4.8 (–4.3 to 11.9) | 0.963 |
| Medical history | |||||||||
| CV disease or risk factors (n=1461) | 54 (78.3) | 407 (57.5) | 0.001 | 20.8 (8.4 to 30.2) | 75 (72.1) | 359 (61.9) | 0.046 | 10.2 (–0.3 to 19.3) | 0.179 |
| Coronary artery disease (n=966) | 17 (42.5) | 114 (25.1) | 0.017 | 17.4 (1.7 to 34.3) | 45 (57.0) | 151 (38.4) | 0.002 | 18.6 (5.9 to 30.5) | 0.927 |
| Hypertension (n=756) | 22 (71.0) | 142 (35.1) | <0.001 | 35.9 (16.0 to 50.7) | 17 (47.2) | 94 (33.0) | 0.091 | 14.2 (–3.0 to 32.1) | 0.094 |
| Diabetes mellitus (n=745) | 12 (41.4) | 56 (14.6) | <0.001 | 26.8 (9.0 to 46.5) | 12 (28.6) | 59 (20.3) | 0.22 | 8.3 (–5.1 to 25.1) | 0.079 |
| Hypercholesterolaemia (n=679) | 8 (36.4) | 81 (23.2) | 0.161 | 13.1 (–5.8 to 36.4) | 19 (45.2) | 62 (23.3) | 0.003 | 21.9 (5.8 to 38.6) | 0.527 |
CV disease or risk factors; a history of previous coronary artery disease, heart failure, stroke, cardiac arrhythmia, hypertension and/or diabetes (patient reported).
Coronary artery disease: history of prior MI, PCI, CABG, stable or unstable angina pectoris (patient reported).
*P value comparing retrosternal or left/right side thorax versus other locations of pain together (restrosternal, left/right side thorax, back/shoulder, epigastric region).
†Pressing/heavy/tightening pain versus other types of pain (stabbing, burning, cramping, tearing). Stabbing pain: stabbing versus other types of pain (pressing/heavy/tightening, burning, cramping, tearing).
‡P value comparing radiation arm or back/shoulder or jaws versus no radiation.
ACS, acute coronary syndrome; ANS, autonomous nervous system; CABG, coronary artery bypass graft; CV, cardiovascular; MI, myocardial infarction; OHS-PC, out-of-hours primary care; PCI, Percutaneous coronary intervention.