Does sex influence triage decision and time to initial electrocardiogram?

Abstract

Study objectives: We determine whether women receive a lower triage severity level or experience longer times to initial ECG compared with men. Methods: We prospectively enrolled a convenience sample of low-risk chest pain patients to our emergency department observation unit. Low risk was defined as having atypical clinical symptomatology with no significant ECG changes and troponin less than 0.1 ng/mL. Triage acuity levels were recorded by the triage nurse using the Emergency Severity Index (ESI) 5-level triage system (1=highest acuity, 5=lowest acuity). Generally, patients with chest pain should be triaged as ESI Level 2. ECG time was abstracted from the original ECG. A χ2 statistic and odds ratio were calculated to determine the difference between triage levels between sexes. Student's t test was performed to analyze differences in mean time to initial ECG between sexes. Results: Two hundred seventy-four patients were enrolled (139 men, 135 women). No differences between sex were found according to triage score (χ2=0.016, P=.99, ESI Level 2, men=106 [51%], women=103 [49%]; ESI Level 3, men=32 [52%], women=30 [48%]). There was no difference in mean time to initial ECG found between sexes (men 55 minutes, SD=70 minutes; women 62 minutes, SD=80 minutes), t=–0.769, P=.44). The overall difference between groups was 7 minutes. Conclusion: Women did not experience lower acuity triage assignments or longer times to initial ECG compared with men in our sample. Study objectives: We determine whether women receive a lower triage severity level or experience longer times to initial ECG compared with men. Methods: We prospectively enrolled a convenience sample of low-risk chest pain patients to our emergency department observation unit. Low risk was defined as having atypical clinical symptomatology with no significant ECG changes and troponin less than 0.1 ng/mL. Triage acuity levels were recorded by the triage nurse using the Emergency Severity Index (ESI) 5-level triage system (1=highest acuity, 5=lowest acuity). Generally, patients with chest pain should be triaged as ESI Level 2. ECG time was abstracted from the original ECG. A χ2 statistic and odds ratio were calculated to determine the difference between triage levels between sexes. Student's t test was performed to analyze differences in mean time to initial ECG between sexes. Results: Two hundred seventy-four patients were enrolled (139 men, 135 women). No differences between sex were found according to triage score (χ2=0.016, P=.99, ESI Level 2, men=106 [51%], women=103 [49%]; ESI Level 3, men=32 [52%], women=30 [48%]). There was no difference in mean time to initial ECG found between sexes (men 55 minutes, SD=70 minutes; women 62 minutes, SD=80 minutes), t=–0.769, P=.44). The overall difference between groups was 7 minutes. Conclusion: Women did not experience lower acuity triage assignments or longer times to initial ECG compared with men in our sample.