AUTHOR=Exalto Lieza G. , van Doorn Sander , Erkelens D. Carmen A. , Smit Karin , Rutten Frans H. , Kappelle L. Jaap , Zwart Dorien L. M. 

TITLE=Call Characteristics of Patients Suspected of Transient Ischemic Attack (TIA) or Stroke During Out-of-Hours Service: A Comparison Between Men and Women

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.669090

DOI=10.3389/fneur.2021.669090

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> In the Netherlands, a digital decision support system for telephone triage at out-of-hours services in primary care (OHS-PC) is used. Differences in help-seeking behavior between men and women when transient ischemic attack (TIA) or stroke is suspected could potentially affect telephone triage and allocation of urgency.</p><p><bold>Aim:</bold> To assess patient and call characteristics and allocated urgencies between women and men who contacted OHS-PC with suspected TIA/stroke.</p><p><bold>Methods:</bold> A cross-sectional study of 1,266 telephone triage recordings of subjects with suspected neurological symptoms calling the OHS-PC between 2014 and 2016. The allocated urgencies were derived from the electronic medical records of the OHS-PC and the final diagnosis from the patient's own general practitioner, including diagnoses based on hospital specialist letters.</p><p><bold>Results:</bold> Five hundred forty-six men (mean age = 67.3 ± 17.1) and 720 women (mean age = 69.6 ± 19.5) were included. TIA/stroke was diagnosed in 294 men (54%) (mean age = 72.3 ± 13.6) and 366 women (51%) (mean age = 78.0 ± 13.8). In both genders, FAST (face-arm-speech test) symptoms were common in TIA/stroke (men 78%, women 82%) but also in no TIA/stroke (men 63%, women 62%). Men with TIA/stroke had shorter call durations than men without TIA/stroke (7.10 vs. 8.20 min, <italic>p</italic> = 0.001), whereas in women this difference was smaller and not significant (7.41 vs. 7.56 min, <italic>p</italic> = 0.41). Both genders were allocated high urgency in 75% of the final TIA/stroke cases.</p><p><bold>Conclusion:</bold> Overall, patient and call characteristics are mostly comparable between men and women, and these only modestly assist in identifying TIA/stroke. There were no gender differences in allocated urgencies after telephone triage in patients with TIA/stroke.</p>