A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay
Objective: The purpose of this study was to assess the impact of adoption of a new cardiac chest pain pathway that included hs-cTnI in the emergency department (ED) when evaluating chest pain patients. Methods: A new pathway incorporating both hs-cTnI testing (Seimens Healthineers Atellica) and risk...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-10-01
|
| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024141953 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846170235518844928 |
|---|---|
| author | Abby E. Roetger Christopher D. McKinney De B. Winter III Charmaine Lewis Kristopher Swiger Claire M. Corbett Gregory Hall Adam David Austin Gratton |
| author_facet | Abby E. Roetger Christopher D. McKinney De B. Winter III Charmaine Lewis Kristopher Swiger Claire M. Corbett Gregory Hall Adam David Austin Gratton |
| author_sort | Abby E. Roetger |
| collection | DOAJ |
| description | Objective: The purpose of this study was to assess the impact of adoption of a new cardiac chest pain pathway that included hs-cTnI in the emergency department (ED) when evaluating chest pain patients. Methods: A new pathway incorporating both hs-cTnI testing (Seimens Healthineers Atellica) and risk stratification tools was developed. The impact of the new algorithm was assessed through a retrospective observational review of patients admitted to the ED with chest pain before implementation and after implementation. Before implementation, the conventional Seimens troponin Vista assay was utilized without a defined algorithmic approach. Bivariate analyses were performed comparing the time periods to determine differences in patient discharge dispositions, length of stay, outcomes, and rate of diagnostic cardiac catheterization. Results: The proportion of patients discharged from the ED increased while the proportion of patients placed in observation or admitted as in-patient decreased. Variation amongst providers regarding patient disposition decreased. The stress testing rate of patients placed in observation decreased over baseline. There was no change in 30-day MACE rate, but there was a decrease in 30-day MI rate. Conclusions: The new standardized hs-cTnI algorithm approach is safe as demonstrated by no change in 30-day MACE and is also more appropriate and efficient for patients presenting to the ED with chest pain compared to the non-standardized approach with cTnI used previously. |
| format | Article |
| id | doaj-art-64cc9eda99a24340b9af5b1c3e829628 |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-64cc9eda99a24340b9af5b1c3e8296282024-11-12T05:18:57ZengElsevierHeliyon2405-84402024-10-011020e38164A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assayAbby E. Roetger0Christopher D. McKinney1De B. Winter III2Charmaine Lewis3Kristopher Swiger4Claire M. Corbett5Gregory Hall6Adam David7Austin Gratton8Institute of Safety and Quality, Novant Health, Wilmington, N.C., USADepartment of Pathology, Novant Health New Hanover Regional Medical Center, Wilmington, N.C., USA; Corresponding author.Emergency Medicine, Novant Health New Hanover Regional Medical Center, Wilmington, N.C., USAHospital Medicine, Novant Health Inpatient Care Specialists, Novant Health New Hanover Regional Medical Center, Wilmington, N.C., USAHeart and Vascular Institute, Novant Health New Hanover Regional Medical Center, Wilmington, N.C., USAInstitute of Safety and Quality, Novant Health, Wilmington, N.C., USAAnesthesiology, Novant Health New Hanover Regional Medical Center, Wilmington, N.C., USADigital Products and Services, Novant Health, Wilmington, N.C., USAResearch Division, South East Area Health Education Center, Novant Health New Hanover Regional Medical Center, Wilmington, N.C., USAObjective: The purpose of this study was to assess the impact of adoption of a new cardiac chest pain pathway that included hs-cTnI in the emergency department (ED) when evaluating chest pain patients. Methods: A new pathway incorporating both hs-cTnI testing (Seimens Healthineers Atellica) and risk stratification tools was developed. The impact of the new algorithm was assessed through a retrospective observational review of patients admitted to the ED with chest pain before implementation and after implementation. Before implementation, the conventional Seimens troponin Vista assay was utilized without a defined algorithmic approach. Bivariate analyses were performed comparing the time periods to determine differences in patient discharge dispositions, length of stay, outcomes, and rate of diagnostic cardiac catheterization. Results: The proportion of patients discharged from the ED increased while the proportion of patients placed in observation or admitted as in-patient decreased. Variation amongst providers regarding patient disposition decreased. The stress testing rate of patients placed in observation decreased over baseline. There was no change in 30-day MACE rate, but there was a decrease in 30-day MI rate. Conclusions: The new standardized hs-cTnI algorithm approach is safe as demonstrated by no change in 30-day MACE and is also more appropriate and efficient for patients presenting to the ED with chest pain compared to the non-standardized approach with cTnI used previously.http://www.sciencedirect.com/science/article/pii/S2405844024141953High sensitivity troponinChest pain algorithmPatient outcomes |
| spellingShingle | Abby E. Roetger Christopher D. McKinney De B. Winter III Charmaine Lewis Kristopher Swiger Claire M. Corbett Gregory Hall Adam David Austin Gratton A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay Heliyon High sensitivity troponin Chest pain algorithm Patient outcomes |
| title | A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay |
| title_full | A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay |
| title_fullStr | A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay |
| title_full_unstemmed | A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay |
| title_short | A patient-centric chest pain management approach utilizing a high sensitivity Troponin-I assay |
| title_sort | patient centric chest pain management approach utilizing a high sensitivity troponin i assay |
| topic | High sensitivity troponin Chest pain algorithm Patient outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024141953 |
| work_keys_str_mv | AT abbyeroetger apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT christopherdmckinney apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT debwinteriii apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT charmainelewis apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT kristopherswiger apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT clairemcorbett apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT gregoryhall apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT adamdavid apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT austingratton apatientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT abbyeroetger patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT christopherdmckinney patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT debwinteriii patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT charmainelewis patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT kristopherswiger patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT clairemcorbett patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT gregoryhall patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT adamdavid patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay AT austingratton patientcentricchestpainmanagementapproachutilizingahighsensitivitytroponiniassay |