Effect of transitioning from conventional cardiac troponin to high-sensitivity cardiac troponin on resource utilization- a single center experience.

Autor: Koirala S; Department of Internal Medicine, Rush University Medical Center, 600 S. Paulina St., Chicago, IL 60612, USA. Electronic address: sushant_koirala@rush.edu., Danley K; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: kelsey_t_danley@rush.edu., Kerolos M; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: mina_m_kerolos@rush.edu., Chu J; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: jian_chu@rush.edu., Yucebay E; Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: elif_yucebay@rush.edu., Purim-Shem-Tov Y; Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: Yanina_Purim-Shem-Tov@rush.edu., Volgman AS; Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: Annabelle_Volgman@rush.edu., Attanasio S; Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. Electronic address: steve_attanasio@rush.edu.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2024 Jun; Vol. 80, pp. 174-177. Date of Electronic Publication: 2024 Apr 11.
DOI: 10.1016/j.ajem.2024.04.007
Abstrakt: Background: Compared to conventional cardiac troponin (cTn), the high-sensitivity cardiac troponin (hs-cTn) assay is associated with improved detection of myocardial infarction (MI).
Methods: We performed a descriptive retrospective analysis of resource utilization at Rush University Medical Center over the transition period (July 1, 2021) from a cTn to a hs-cTn assay. Inclusion criteria included emergency department (ED) encounters between January 1 to December 31, 2021, with chief complaints of "chest pain" or "dyspnea" with associated troponin orders. The primary endpoint was the percentage of ED discharges. Secondary endpoints included the number of cardiac studies ordered. Univariable comparisons of these endpoints were performed using Student's t-test for continuous variables and Chi-square tests for binary/categorical variables.
Results: A total of 5113 encounters were analyzed. Hs-cTn was associated with an overall increase in ED patient discharges with negative troponin tests (44.1% vs. 29.9%, P < 0.01). In terms of cardiac testing per encounter, hs-cTn was associated with significant increases in the number of troponin tests (1.9 vs. 1.6, P < 0.01), electrocardiograms (3.0 vs. 2.9, P = 0.01), and echocardiograms (0.5 vs. 0.4, P < 0.01). There was a significant decrease in the utilization of stress testing (0.21 vs. 0.26, P < 0.01). There was a significant increase in total coronary angiography use during the hs-cTn period compared to cTn (227/2471 (9.2%) vs. 195/2642 (7.4%), P = 0.02).
Conclusion: Transitioning from cTn to hs-cTn was associated with significantly increased ED discharges and an increase in troponin tests, ECG, echocardiograms, and coronary angiograms. There was a decrease in the number of stress tests.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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