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Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services
Adoption of High-sensitivity troponin (hs-cTn) assays by hospitals worldwide is increasing. We sought to determine the effects of a simultaneous state-wide hs-cTn assay introduction on the implementing health service. A quasi-experimental pre–post design was used. Participants included all adult pat...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356092/ https://www.ncbi.nlm.nih.gov/pubmed/32560184 http://dx.doi.org/10.3390/jcm9061883 |
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author | Greenslade, Jaimi H. Parsonage, William Foran, Laura McCormack, Louise Ashover, Sarah Milburn, Tanya Berndt, Sara Than, Martin Brain, David Cullen, Louise |
author_facet | Greenslade, Jaimi H. Parsonage, William Foran, Laura McCormack, Louise Ashover, Sarah Milburn, Tanya Berndt, Sara Than, Martin Brain, David Cullen, Louise |
author_sort | Greenslade, Jaimi H. |
collection | PubMed |
description | Adoption of High-sensitivity troponin (hs-cTn) assays by hospitals worldwide is increasing. We sought to determine the effects of a simultaneous state-wide hs-cTn assay introduction on the implementing health service. A quasi-experimental pre–post design was used. Participants included all adult patients presenting to 21 Australian hospitals who had troponin testing commenced within the Emergency Department (ED). Data were collected for 124,357 episodes of care between 30 April 2018 and 23 April 2019; six months pre- and six months post-implementation of the assay. The primary outcome was hospital length of stay (LOS). Secondary outcomes included ED LOS, 90-day cardiovascular mortality, elevated troponin, diagnosis of acute myocardial infarction (AMI), admission to a cardiology ward, invasive cardiac procedures, and total hospital costs. Following hs-cTn implementation, there was a 1.9-h (95% CI: −2.9 to −1.0 h) reduction in overall LOS. This equated to a cost saving of over 9 million Australian dollars per year. There was no increase in diagnosis of AMI, invasive cardiac procedures or ward admissions. The use of hs-cTn assays facilitates important benefits for health services by enabling more rapid evaluation protocols within the ED. This benefit may be considerable given the large cohort of emergency patients with possible ACS. |
format | Online Article Text |
id | pubmed-7356092 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73560922020-07-31 Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services Greenslade, Jaimi H. Parsonage, William Foran, Laura McCormack, Louise Ashover, Sarah Milburn, Tanya Berndt, Sara Than, Martin Brain, David Cullen, Louise J Clin Med Article Adoption of High-sensitivity troponin (hs-cTn) assays by hospitals worldwide is increasing. We sought to determine the effects of a simultaneous state-wide hs-cTn assay introduction on the implementing health service. A quasi-experimental pre–post design was used. Participants included all adult patients presenting to 21 Australian hospitals who had troponin testing commenced within the Emergency Department (ED). Data were collected for 124,357 episodes of care between 30 April 2018 and 23 April 2019; six months pre- and six months post-implementation of the assay. The primary outcome was hospital length of stay (LOS). Secondary outcomes included ED LOS, 90-day cardiovascular mortality, elevated troponin, diagnosis of acute myocardial infarction (AMI), admission to a cardiology ward, invasive cardiac procedures, and total hospital costs. Following hs-cTn implementation, there was a 1.9-h (95% CI: −2.9 to −1.0 h) reduction in overall LOS. This equated to a cost saving of over 9 million Australian dollars per year. There was no increase in diagnosis of AMI, invasive cardiac procedures or ward admissions. The use of hs-cTn assays facilitates important benefits for health services by enabling more rapid evaluation protocols within the ED. This benefit may be considerable given the large cohort of emergency patients with possible ACS. MDPI 2020-06-16 /pmc/articles/PMC7356092/ /pubmed/32560184 http://dx.doi.org/10.3390/jcm9061883 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Greenslade, Jaimi H. Parsonage, William Foran, Laura McCormack, Louise Ashover, Sarah Milburn, Tanya Berndt, Sara Than, Martin Brain, David Cullen, Louise Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services |
title | Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services |
title_full | Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services |
title_fullStr | Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services |
title_full_unstemmed | Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services |
title_short | Widespread Introduction of a High-Sensitivity Troponin Assay: Assessing the Impact on Patients and Health Services |
title_sort | widespread introduction of a high-sensitivity troponin assay: assessing the impact on patients and health services |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356092/ https://www.ncbi.nlm.nih.gov/pubmed/32560184 http://dx.doi.org/10.3390/jcm9061883 |
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