title: Gender differences in pre-hospital time delay and symptom presentation in patients suspected of acute coronary syndrome in primary care.
abstract: OBJECTIVE
  To describe gender differences in pre-hospital delay times and symptom presentation in patients suspected of acute coronary syndrome (ACS) in a primary care setting.
  
  
  METHODS
  Over 150 participating GPs included 298 consecutive patients suspected of ACS (52% female, mean age 66 years, 22% eventually diagnosed with ACS according to international guidelines) in a 28-month time period. Data on time from call for help until GP consultation (doctor delay) were prospectively collected, while the time from onset of symptoms until call for help (patient delay) was recorded by the GP at the time of arrival at the patient, together with patient characteristics, including age, sex, previous medical history, chest pain, radiation of chest pain and nausea/sweating.
  
  
  RESULTS
  Median doctor delay was 45 [interquartile range (IQR) 20-55] minutes in women and 33 (IQR 26-72) minutes in men (P = 0.01). Median patient delay was 108 (IQR 39-348) minutes in women and 180 (IQR 48-396) minutes in men (P = 0.20). Women reported spreading chest pain more often than men (68% versus 57%, P = 0.06). Women diagnosed with ACS were older than men (mean 75 years versus 65 years, P < 0.001).
  
  
  CONCLUSIONS
  In patients suspected of ACS in primary care, no differences were found in patient delay, but doctor delay was longer in women than in men. Symptom presentation was largely similar between men and women, although women tended to report 'spreading' chest pain more often.
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. madeleinebruinsslot@gmail.com
authors: Madeleine H E
authors: MH
authors: Bruins Slot
authors: Frans H
authors: FH
authors: Rutten
authors: Geert J M G
authors: GJ
authors: van der Heijden
authors: Pieter A
authors: PA
authors: Doevendans
authors: E Gijs
authors: EG
authors: Mast
authors: Ad C
authors: AC
authors: Bredero
authors: Jan F C
authors: JF
authors: Glatz
authors: Arno W
authors: AW
authors: Hoes
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D016009:Chi-Square Distribution; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013546:Sweating; D013997:Time Factors