Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Decreased admissions and hospital costs with a neutral effect on mortality following lowering of the troponin T cutoff point to the 99th percentile
Univ Gothenburg, Sahlgrenska Acad, Sahlgrenska Univ Hosp, Dept Med, Gothenburg, Sweden..
Univ Gothenburg, Sahlgrenska Acad, Sahlgrenska Univ Hosp, Dept Clin Chem & Transfus Med, Gothenburg, Sweden..
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Kardiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).ORCID-id: 0000-0002-5795-0061
Univ Gothenburg, Sahlgrenska Acad, Sahlgrenska Univ Hosp, Dept Med, Gothenburg, Sweden..
Vise andre og tillknytning
2017 (engelsk)Inngår i: Cardiology journal, ISSN 1897-5593, Vol. 24, nr 6, s. 612-622Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background:

The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources.

Methods:

Clinical and laboratory data from patients with chest pain or dyspnea at the emergency department (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012. Myocardial infarction (MI) was diagnosed at the discretion of the attending clinicians responsible for the patient.

Results:

Following lowering of the hs-cTnT cutoff point fewer ED patients with chest pain or dyspnea as the principal complaint were analyzed with an hs-cTnT sample (81% vs. 72%, p < 0.001). Overall 30-day mortality was unaffected but increased among patients not analyzed with an hs-cTnT sample (5.3% vs. 7.6%, p < 0.001). The MI frequency was unchanged (4.0% vs. 3.9%, p = 0.72) whereas admission rates decreased (51% vs. 45%, p < 0.001) as well as hospital costs. Coronary angiographies were used more frequently (2.8% vs. 3.3%, p = 0.004) but with no corresponding change in coronary interventions.

Conclusions:

At the participating hospital, lowering of the hs-cTnT cutoff point to the 99th percentile decreased admissions and hospital costs but did not result in any apparent prognostic or treatment benefits for the patients.

sted, utgiver, år, opplag, sider
2017. Vol. 24, nr 6, s. 612-622
Emneord [en]
high-sensitivity troponin T, hs-cTnT, 99th percentile, mortality, hospital admissions
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-340328DOI: 10.5603/CJ.a2017.0079ISI: 000419183400004PubMedID: 28695975OAI: oai:DiVA.org:uu-340328DiVA, id: diva2:1178755
Tilgjengelig fra: 2018-01-30 Laget: 2018-01-30 Sist oppdatert: 2018-01-30bibliografisk kontrollert

Open Access i DiVA

Fulltekst mangler i DiVA

Andre lenker

Forlagets fulltekstPubMed

Søk i DiVA

Av forfatter/redaktør
Lindahl, Bertil
Av organisasjonen

Søk utenfor DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 16 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf