Patients discharged with elevated baseline high-sensitive cardiac troponin T from the emergency department
BACKGROUND: Elevated levels of high-sensitive cardiac troponin T (hs-cTnT) are linked to poor prognosis among emergency department (ED) patients.
OBJECTIVE: Examine the effect of our ED risk assessment among patients with suspected acute coronary syndrome (ACS) and elevated baseline hs-cTnT levels.
DESIGN: Observational cohort study of 16776 ED patients with chest pain or dyspnoea and a hs-cTnT sample analyzed at the time of the ED visit. Of these 1480 patients were sent home with elevated hs-cTnT levels (>14 ng/L).
METHODS: Analysis of clinical and laboratory data from the local hospital and data from the National Board of Health and Welfare.
RESULTS: Admitted patients had 11% and discharged patients had 1.2% 90-day mortality indicating effective risk assessment of patients with suspected ACS. However, if the suspected ACS patient presented with hs-cTnT between 14 and 22 ng/L, the 90-day mortality was 4.1% among discharged and 6.7% among admitted patients. Among discharged patients, an hs-cTnT level above 14 ng/L was a higher independent risk factor for 90-day mortality (HR 3.3, 95% CI 2.9-3.7, p < 0.001) than if the patient was triaged as a high-risk patient (HR 1.6, 95% CI 1.1-1.8, p < 0.001).
CONCLUSIONS: Our ED risk assessment was less effective among patients presenting with elevated hs-cTnT levels.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
|---|---|
| Enthalten in: |
Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals - 26(2021), 5 vom: 01. Juli, Seite 410-416 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bjurman, Christian [VerfasserIn] |
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| Links: |
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| Themen: |
Acute coronary syndrome |
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| Anmerkungen: |
Date Completed 09.12.2021 Date Revised 24.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/1354750X.2021.1917662 |
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| funding: |
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|---|---|
| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM324599501 |
|---|
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| 500 | |a Date Completed 09.12.2021 | ||
| 500 | |a Date Revised 24.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Elevated levels of high-sensitive cardiac troponin T (hs-cTnT) are linked to poor prognosis among emergency department (ED) patients | ||
| 520 | |a OBJECTIVE: Examine the effect of our ED risk assessment among patients with suspected acute coronary syndrome (ACS) and elevated baseline hs-cTnT levels | ||
| 520 | |a DESIGN: Observational cohort study of 16776 ED patients with chest pain or dyspnoea and a hs-cTnT sample analyzed at the time of the ED visit. Of these 1480 patients were sent home with elevated hs-cTnT levels (>14 ng/L) | ||
| 520 | |a METHODS: Analysis of clinical and laboratory data from the local hospital and data from the National Board of Health and Welfare | ||
| 520 | |a RESULTS: Admitted patients had 11% and discharged patients had 1.2% 90-day mortality indicating effective risk assessment of patients with suspected ACS. However, if the suspected ACS patient presented with hs-cTnT between 14 and 22 ng/L, the 90-day mortality was 4.1% among discharged and 6.7% among admitted patients. Among discharged patients, an hs-cTnT level above 14 ng/L was a higher independent risk factor for 90-day mortality (HR 3.3, 95% CI 2.9-3.7, p < 0.001) than if the patient was triaged as a high-risk patient (HR 1.6, 95% CI 1.1-1.8, p < 0.001) | ||
| 520 | |a CONCLUSIONS: Our ED risk assessment was less effective among patients presenting with elevated hs-cTnT levels | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Cardiovascular disease | |
| 650 | 4 | |a acute coronary syndrome | |
| 650 | 4 | |a cardiac troponin | |
| 650 | 4 | |a chest pain | |
| 650 | 4 | |a emergency department risk assessment | |
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| 650 | 7 | |a Troponin T |2 NLM | |
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| 700 | 1 | |a Zangana, Soza |e verfasserin |4 aut | |
| 700 | 1 | |a Salahuddin, Sabin |e verfasserin |4 aut | |
| 700 | 1 | |a Holzmann, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Carlson, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Hammarsten, Ola |e verfasserin |4 aut | |
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