Appropriateness of troponin testing in emergency department at a tertiary care hospital in Saudi Arabia

OBJECTIVES: To assess the appropriateness of troponin testing in the Emergency Department (ED) at King Saud Medical City, Riyadh, Saudi Arabia. METHODS: This record-based cross-sectional study examined the electronic records of adult patients who underwent a troponin test following admission to hospital’s ED from January to March 2020. RESULTS: A total of 367 troponin tests were ordered for 233 patients. Majority of these orders were appropriate (55%) while the remaining (45%) were adjudged as inappropriate. Among the inappropriate orders, majority were single (61%) compared to serial ones (39%). Overall, there were 166 inappropriate orders and the estimated direct monthly cost for inappropriate testing was 49,800 Saudi Riyals in the emergency department alone. CONCLUSION: Approximately half of the troponin tests ordered in the ED were inappropriate. The overall financial burden of inappropriate testing greatly impacts patient management and resource utilization. These findings emphasize the pressing need for institutional clinical guidelines to guide appropriate use of troponin testing.