Istat troponin procedure12/14/2023 ![]() ![]() To the best of the authors’ knowledge, this study is the first of its kind in the region to study the pattern of troponin testing in the ED of a large tertiary care centre. ![]() A Mann-Whitney test was used to compare associations with LOS.Įthical approval for this study was obtained from the Medical Ethics & Research Committee of the College of Medicine & Health Sciences, Sultan Qaboos University (MREC #1122). A Chi-squared test was used to compare categorical variables between groups and a t-test was used to compare mean ages. Means and standard deviations were used to describe continuous normally distributed variables, while non-normally distributed variables were described as medians and interquartile ranges. All categorical variables were presented as frequencies and percentages. A P value of <0.050 was considered statistically significant. 7 The final diagnosis of each patient was categorised as either cardiac or non-cardiac, with cardiac diagnoses including heart failure, an ACS, atrial fibrillation or other forms of arrhythmia.Īll statistical analyses were performed using the Statistical Package for the Social Science (SPSS), Version 21.0 (IBM Corp., Armonk, New York, USA). Epigastric pain was included as a cardiac symptom as it is potentially indicative of an atypical presentation of angina furthermore, it is often difficult to distinguish between epigastric and retrosternal discomfort. The presenting complaints of the patients were classified as either cardiac or non-cardiac, with presenting cardiac complaints including chest pain, palpitations, breathlessness and epigastric pain. Troponin levels were considered positive at ≥0.04 μg/mL and negative at <0.04 μg/mL, as per the reference levels recommended by the manufacturer of the assay kit (AccuTnl+3 Reagent Kit, Beckman Coulter Inc., Brea, California, USA). Patient data were obtained from the hospital’s electronic records. The month of July was chosen at random for the study period. Patients who presented with a ST-elevation MI (STEMI) were excluded. This retrospective study included all adult patients ≥18 years old undergoing cTn-I testing following their admission to the ED of SQUH during July 2015. 5, 6 This study therefore aimed to review patterns of troponin testing among patients attending the ED of the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman, and to examine whether initial troponin test results had an effect on patient management, especially length of hospital stay (LOS). 4 As the main reason for testing cardiac troponin is to rule out an acute coronary syndrome (ACS), it is thus essential that troponin is only checked in circumstances where the probability of ischaemic heart disease is high and an ACS is suspected, especially as indiscriminate troponin testing can lead to unnecessary investigations or a misdiagnosis. ![]() However, because the troponin test is very sensitive, an inevitable number of false-positive results is to be expected. Of these, the most widely used and extensively validated biomarkers for detecting cardiac cellular injury are cardiac troponins T and I (cTn-I) as they have a high sensitivity to and specificity for myocardial damage. Necessary diagnostic investigations include a thorough patient history and physical examination, chest X-rays, 12-lead electrocardiography (ECG) and blood tests for myocardial injury biomarkers. 1 As there are many causes of chest pain, the emergency physician has the responsibility of ruling out potentially life-threatening and serious conditions, such as a myocardial infarction (MI), aortic dissection or pulmonary embolism. Accordingly, a thoroughly clinical evaluation should be conducted prior to a test request.Ĭhest pain is one of the most common reasons for emergency department (ED) attendance. The findings of this study highlight the need for protocols to guide troponin testing as, unless indicated, it can lead to unnecessary investigations and delayed patient discharge. ![]()
0 Comments
Leave a Reply.AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |