Troponin Testing in the Emergency Department Real world experience
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 4
Abstract
Objectives: Te aim of this study was to examine patterns of troponin testing in the emergency department of a large tertiary care hospital in Oman and to determine its effect on patient management, including length of hospital stay (LOS). Methods: Tis retrospective study analysed the medical records of all adult patients undergoing troponin testing in the emergency department of the Sultan Qaboos University Hospital, Muscat, Oman, during the month of July 2015. Patients who presented with an ST-elevation myocardial infarction were excluded. Results: A total of 4,845 patients attended the emergency department during the study period; of these, troponin tests were ordered for 588 patients. Te majority of the patients had negative troponin test results (81.3%). Chest pain, palpitations and breathlessness were the most common presenting complaints for those with positive troponin results. However, 41.8% of patients did not have any cardiac symptoms. Individuals with positive troponin tests had a signifcantly longer LOS compared to those with negative tests (mean: three versus one day; P = 0.001). In total, only 28.2% of those with positive troponin test results had fnal diagnoses associated with a cardiac condition, such as heart failure, an acute coronary syndrome (ACS), atrial fbrillation or other types of arrhythmia. Conclusion: A positive troponin test was associated with increased LOS; however, only a small proportion of these patients had a fnal diagnosis associated with a cardiac condition. Guidelines should be provided to ensure that troponin testing is performed only in cases where an ACS is suspected.
Authors and Affiliations
Mohammed Al-Maskari| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Mahmoud Al-Makhdami| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Hatim Al-Lawati| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Hafdh Al-Hadi| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Sunil K. Nadar| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
Keywords
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- EP ID EP14815
- DOI 10.18295/squmj.2017.17.04.004
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