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The following is a summary of “Diagnosing acute coronary syndrome in telephone triage: does it matter who initially calls? A cross-sectional study,” published in the April 2025 issue of BMC Primary Care by Delissen et al. 

Adequate triage of patients with acute coronary syndrome (ACS) symptoms is essential for timely intervention. Caller identity may influence triage outcomes and urgency allocation. 

Researchers conducted a retrospective study to assess whether surrogate-initiated calls are associated with higher urgency and greater odds of ACS compared to patient-initiated calls. 

They conducted a cross-sectional study of patients with symptoms suggestive of ACS who called the out-of-hours service in primary care (OHS-PC). Calls were classified as “patient-initiated call” or “surrogate call.” Call and patient characteristics were collected. Odds ratios (OR) were calculated for the relationship between the type of call and urgency allocation, ACS, and ACS or other life-threatening event, stratified by gender. 

The results showed that 2,428 recordings were included for analysis. Around half were surrogate calls, which more often received high urgency (80.0%) than patient-initiated calls (57.8%), OR 2.92 (95%CI 2.44–3.50); in women OR 3.46 (95%CI 2.70–4.45), in men OR 2.42 (95%CI 1.86–3.16). Overall, 11.0% were diagnosed with ACS; in women 8.0%, in men 14.7%. In the surrogate call group, 14.4% were diagnosed with ACS, compared to 7.6% in the patient-initiated call group, OR 2.04 (95%CI 1.57–2.67). In women, OR 2.46 (95%CI 1.63–3.77), in men OR 1.69 (95%CI 1.20–2.41). 

Investigators found that surrogate calls for patients with symptoms suggestive of ACS were more likely to receive high urgency, and these patients had twice the risk of ACS. This effect was similar in both women and men. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02801-5