NTS high urgency n=1208 (59.7%) | NTS low urgency n=815 (40.3%) | P value | |
Patient characteristics | |||
Mean (SD) age, years | 62.7 (18.2) | 53.1 (19.9) | <0.001 |
Female sex | 683 (56.5) | 428 (52.5) | 0.074 |
Call characteristics | |||
Mean (SD) total call duration, min | 6:57 (3:42) | 8:30 (3:48) | <0.001 |
Mean (SD) patients’ introduction duration, min | 0:18 (0:12) | 0:21 (0:14) | <0.001 |
Triage nurse consulted the GP | 643 (53.2) | 418 (51.3) | 0.391 |
Someone else called on behalf of patient | 711 (58.9) | 317 (38.9) | <0.001 |
Caller expressed concerns | 500 (92.1) | 413 (86.4) | 0.003 |
NTS main complaints | |||
ABCD unstable | 93 (7.7) | 2 (0.2) | <0.001 |
Chest pain | 867 (71.8) | 668 (82.0) | <0.001 |
Shortness of breath | 121 (10.0) | 43 (5.3) | <0.001 |
Palpitations | 33 (2.7) | 27 (3.3) | 0.45 |
Back pain | 19 (1.6) | 7 (0.9) | 0.162 |
Dizziness | 11 (0.9) | 8 (1.0) | 0.871 |
Arm problems | 2 (0.2) | 8 (1.0) | 0.01 |
Other | 62 (5.1) | 52 (6.4) | 0.233 |
NTS triage criteria | |||
Chest pain | 1088 (93.5) | 738 (93.5) | 0.954 |
Shortness of breath | 664 (71.0) | 337 (53.9) | <0.001 |
Chest pain duration <12 hours | 843 (81.3) | 453 (62.5) | <0.001 |
Pain intensity severe (NRS >7, range 1–10) | 224 (46.7) | 83 (22.1) | <0.001 |
Pressing heavy chest pain* | 623 (73.4) | 309 (47.5) | <0.001 |
Stabbing chest pain* | 127 (15.0) | 220 (33.8) | <0.001 |
Chest pain located retrosternal† | 401 (51.2) | 196 (30.0) | <0.001 |
Chest pain located left or right on thorax† | 224 (28.6) | 349 (53.4) | <0.001 |
Radiation of chest pain to any location | 662 (71.5) | 341 (54.3) | <0.001 |
Radiation to the arm | 273 (50.8) | 151 (34.5) | <0.001 |
Radiation to the shoulder blades | 206 (43.8) | 102 (26.2) | <0.001 |
Radiation to the jaws | 93 (26.1) | 22 (7.1) | <0.001 |
Sweating | 363 (47.7) | 159 (31.5) | <0.001 |
Nausea or vomiting | 308 (55.3) | 137 (39.4) | <0.001 |
Pallor | 187 (39.0) | 55 (22.8) | <0.001 |
Dizziness or (feelings of nearly) fainting | 274 (26.6) | 113 (14.8) | <0.001 |
History of coronary artery disease | 234 (38.6) | 127 (27.1) | <0.001 |
Diabetes mellitus | 98 (23.1) | 62 (14.8) | 0.002 |
Other than NTS items, if they were discussed in triage call | |||
Coin size area of chest pain | 77 (45.3) | 154 (48.0) | 0.571 |
Tingling sensations on chest, hands or elsewhere | 112 (86.8) | 97 (79.5) | 0.121 |
Patient recognised symptoms from previous cardiac event | 152 (30.9) | 76 (21.5) | 0.002 |
CVD risk factors other than diabetes | |||
Hypertension | 190 (43.0) | 116 (28.6) | <0.001 |
Hypercholesterolemia/statin use | 103 (28.0) | 89 (22.0) | 0.056 |
Coronary artery disease: history of myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, stable or unstable angina pectoris (patient reported).
*Pain described by patient. Pressing heavy pain: pressing, heavy or 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 retrosternal or left/right side thorax versus other locations of pain together (retrosternal, left/right side thorax, back/shoulder, epigastric region).
CVD, cardiovascular disease; NRS, Numeric Rating Scale; NTS, Netherlands Triage System; OHS-PC, out-of-hours services for primary care.