Abstract
Abstract 13077: Impact of High Sensitivity Troponin on Hospital Length of Stay and Cardiac Testing in Patients Presenting With Chest Pain: A Retrospective Cohort Study
Circulation (New York, N.Y.), Vol.140(Suppl_1 Suppl 1), pp.A13077-A13077
11/19/2019
DOI: 10.1161/circ.140.suppl_1.13077
Abstract
IntroductionUse of conventional cardiac troponin (cTnT) has posed the issue of prolonged time to diagnosis with troponins drawn 6-8 hours apart. Implementation of high sensitivity cardiac troponin (Hs-cTnT) assays provides a more efficient rule-out process in theory, however, the effects on length of stay (LOS) and ordering of cardiac testing has not been well studied.MethodsWe conducted a single-center, retrospective cohort study consisting of 1,550 patients presenting with chest pain to the Banner University Medical Center - Phoenix emergency department (ED). Data was collected for three months before and after introduction of Hs-cTnT from 2017-2018. The primary intervention was utilization of the cTnT or Hs-cTnT tests. Primary outcomes included length of stay, stress test utilization and cardiac catheterization.ResultsHospital length of stay was significantly reduced by 269.7 minutes after implementation of the Hs-cTnT (OR=0.89; 95% CI 0.84 to 0.94; p<0.001). More cTnT patients were admitted to observation (34.5% vs 26.4%) and inpatient (14.9% vs. 13.4%) compared to the Hs-cTnT patients who were mostly evaluated in the ED (50.5% vs 60.2%, p<0.001). The number of stress tests ordered significantly decreased (9.64% vs. 10.5%, OR=0.27; 95% CI0.38 to 0.86; p=0.007). Left heart catheterization rates were similar between groups (OR=0.89; 95% CI0.47 to 1.32, p=0.38). The intervention group was overall a sicker population evidenced by higher Charlson Comorbidity Index scores and nearly double the rate of aspirin use.ConclusionsImplementation of Hs-cTnT resulted in a significant decrease in LOS by nearly 270 minutes, allowing for both faster detection and rule-out of clinically significant coronary artery disease. In addition, less stress tests were performed despite being a sicker population overall.
Details
- Title: Subtitle
- Abstract 13077: Impact of High Sensitivity Troponin on Hospital Length of Stay and Cardiac Testing in Patients Presenting With Chest Pain: A Retrospective Cohort Study
- Creators
- Allison Bigeh - University of ArizonaJudd Payne - University of ArizonaSumit Agarwal - University of ArizonaPaul Kang - University of ArizonaJoseph Alpert - University of ArizonaJennifer Robinson - Epidemiology and Medicine, The Univ of Iowa-Carver College of Medicine, Iowa City, IAAnkur Mishra - University of Arizona
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.140(Suppl_1 Suppl 1), pp.A13077-A13077
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- DOI
- 10.1161/circ.140.suppl_1.13077
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/19/2019
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984364520702771
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