Evidence map›Paper›PMID 40348999›Full record

ArticleBMC primary care2025

Gender-stratified analyses of symptoms associated with life-threatening events in patients calling out-of-hours primary care for shortness of breath.

Michelle Spek, Dorien L Zwart, Gerardus J H M Reijers, Esther de Groot, Geert-Jan Geersing, Maarten van Smeden, Hester M den Ruijter, Anna S M Dobbe, Mathé Delissen, Frans H Rutten and 1 more

Abstract read
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Michelle SpekDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands. m.spek-3@umcutrecht.nl.
Dorien L ZwartDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Gerardus J H M ReijersDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Esther de GrootDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Geert-Jan GeersingDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Maarten van SmedenDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Hester M den RuijterLaboratory of Experimental Cardiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Anna S M DobbeDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Mathé DelissenDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Frans H RuttenDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.
Roderick P VenekampDepartment of General Practice & Nursing Sciences, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Str. 6.131, P.O. Box 85500, Utrecht, 3508, GA, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWomen and men seem to perceive shortness of breath (SOB) differently. However, it is unknown whether symptom presentation varies between genders during a life-threatening event (LTE).

aimTo assess whether symptoms associated with an LTE vary between women and men with SOB calling out-of-hours primary care (OHS-PC).

methodsCross-sectional study including data from patients contacting two large Dutch OHS-PC centres for SOB between 1 September 2020 and 31 August 2021. We compared symptoms mentioned during triage conversations between patients with and without LTEs (amongst others, acute coronary syndrome, pulmonary embolism, acute heart failure and severe pneumonia), stratified by gender.

resultsWe included 1,861 adults contacting OHS-PC for SOB (mean age 53.3 years, 55.3% women). The risk of an LTE was lower in women than in men (15.0% vs. 18.7%, RR 0.80; 95% CI 0.65-0.98). Patients with LTEs were older, more often had someone else calling for them, a history of cardiovascular disease, cardiovascular medication use and inability to speak full sentences compared to those without LTEs. Differences between women and men were only apparent for calling at night (women: 24.0% vs. 15.2%, p = 0.006, versus men: 18.7% vs. 22.5%, p = 0.300; p-value interaction term: 0.009) and participation of general practitioners during telephone triage (women: 49.4% vs. 49.5%, p = 0.975, versus men: 56.1% vs. 43.0%, p = 0.003; p-value interaction term: 0.033).

conclusionsAmong patients contacting OHS-PC with SOB, about 1 in 6 had an LTE, more often men than women. We found no strong evidence of symptom differences between gender groups predictive of LTEs.

trial registrationThe Netherlands Trial Register, number: NL9682, registration date: 20-08-2021.

Indexed as

After-Hours CareDyspneaPrimary Health CareAdultAgedCross-Sectional StudiesFemaleHeart FailureHumansMaleMiddle AgedNetherlandsSex FactorsTriageGender-differencesGeneral practiceOut-of-hours primary careShortness of breathTelephone triage

Identifiers

PMID40348999
PMCPMC12065261

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.