Table 1

Baseline characteristics of 2023 patients with chest discomfort (chest pain, pressure, tightness, discomfort) calling OHS-PC, divided into high (U1–U2) and low (U3–-5) NTS levels of urgency

NTS high urgency
n=1208 (59.7%)
NTS low urgency
n=815 (40.3%)
P value
Patient characteristics
 Mean (SD) age, years62.7 (18.2)53.1 (19.9)<0.001
 Female sex683 (56.5)428 (52.5)0.074
Call characteristics
 Mean (SD) total call duration, min6:57 (3:42)8:30 (3:48)<0.001
 Mean (SD) patients’ introduction duration, min0:18 (0:12)0:21 (0:14)<0.001
 Triage nurse consulted the GP643 (53.2)418 (51.3)0.391
 Someone else called on behalf of patient711 (58.9)317 (38.9)<0.001
 Caller expressed concerns500 (92.1)413 (86.4)0.003
NTS main complaints
 ABCD unstable93 (7.7)2 (0.2)<0.001
 Chest pain867 (71.8)668 (82.0)<0.001
 Shortness of breath121 (10.0)43 (5.3)<0.001
 Palpitations33 (2.7)27 (3.3)0.45
 Back pain19 (1.6)7 (0.9)0.162
 Dizziness11 (0.9)8 (1.0)0.871
 Arm problems2 (0.2)8 (1.0)0.01
 Other62 (5.1)52 (6.4)0.233
NTS triage criteria
 Chest pain1088 (93.5)738 (93.5)0.954
 Shortness of breath664 (71.0)337 (53.9)<0.001
 Chest pain duration <12 hours843 (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 location662 (71.5)341 (54.3)<0.001
 Radiation to the arm273 (50.8)151 (34.5)<0.001
 Radiation to the shoulder blades206 (43.8)102 (26.2)<0.001
 Radiation to the jaws93 (26.1)22 (7.1)<0.001
 Sweating363 (47.7)159 (31.5)<0.001
 Nausea or vomiting308 (55.3)137 (39.4)<0.001
 Pallor187 (39.0)55 (22.8)<0.001
 Dizziness or (feelings of nearly) fainting274 (26.6)113 (14.8)<0.001
 History of coronary artery disease234 (38.6)127 (27.1)<0.001
 Diabetes mellitus98 (23.1)62 (14.8)0.002
Other than NTS items, if they were discussed in triage call
 Coin size area of chest pain77 (45.3)154 (48.0)0.571
 Tingling sensations on chest, hands or elsewhere112 (86.8)97 (79.5)0.121
 Patient recognised symptoms from previous cardiac event152 (30.9)76 (21.5)0.002
CVD risk factors other than diabetes
 Hypertension190 (43.0)116 (28.6)<0.001
 Hypercholesterolemia/statin use103 (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.