Validation of the Ottawa Troponin Pathway
| Autor: | Muhammad Mukarram, Marie-Joe Nemnom, Jesse Junyi Li, Brandon Lam, Venkatesh Thiruganasambandamoorthy, Ronald A. Booth |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Adult
medicine.medical_specialty Emergency Nursing Chest pain 03 medical and health sciences 0302 clinical medicine Internal medicine Troponin I medicine Humans In patient 030212 general & internal medicine Myocardial infarction Non-ST Elevated Myocardial Infarction Ed crowding biology Adult patients business.industry 030208 emergency & critical care medicine musculoskeletal system medicine.disease Troponin Patient Discharge Baseline characteristics cardiovascular system Cardiology biology.protein medicine.symptom Emergency Service Hospital business Biomarkers |
| Zdroj: | Australasian Emergency Care. 25:37-40 |
| ISSN: | 2588-994X |
| DOI: | 10.1016/j.auec.2021.04.004 |
| Popis: | The Ottawa Troponin Pathway (OTP) was developed to improve Non-ST elevation myocardial infarction (NSTEMI) diagnosis accuracy using 3-h serial conventional troponin I (TnI) measurements. We sought to validate the OTP in patients with TnI values99th percentile upper reference limit (45 ng/L).We conducted a health records review in adult patients with NSTEMI symptoms with at least two serial TnI and at least one45 ng/L at two emergency departments (EDs). We collected baseline characteristics, ED management and disposition. 30-day outcomes included death due to cardiac ischemia, an unknown cause, or NSTEMI.635 patients were included, and 107 patients were diagnosed with NSTEMI within 30-days. 217 patients had at least one TnI value45 ng/L but100 ng/L, of whom 4 patients were diagnosed with NSTEMI. 418 patients had at least one TnI value ≥100 ng/L, and 103 were diagnosed with NSTEMI. The OTP accurately identified all 107 patients with NSTEMI: sensitivity and specificity was 100% (95% CI 96.6%-100%) and 32.2% (95% CI 28.2%-36.4) respectively.The OTP is validated among patients with TnI values above the 99th percentile with symptoms concerning for ACS. Using OTP will allow for early referral and discharge home and improve ED crowding.20180393-01H. |
| Databáze: | OpenAIRE |
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