Key result
Point-of-care testing of cardiac troponin reduced emergency department length of stay and time to disposition, and increased successful discharge home.
Why the study?
Point-of-care testing of cardiac troponin offers shorter turnaround times and may improve timely diagnosis, but its effectiveness for acute coronary syndrome management in the emergency department required systematic examination.
Does point-of-care testing of troponin improve management outcomes for patients with acute coronary syndrome in the emergency department?
Systematic Review
Does point-of-care testing of troponin improve management outcomes for patients with acute coronary syndrome in the emergency department?
Answers are grounded in this paper and cite their sources.
Point-of-care troponin testing can significantly reduce emergency department time to disposition and facilitate successful discharge home for patients with suspected acute coronary syndrome.
Background Early identification of acute coronary syndrome is crucial for a patient's likelihood of survival. Point-of-care testing of cardiac troponin is a rapid test of cardiac troponin that can be conducted closer to where clinical care is delivered, with a significant shorter turnaround time. Point-of-care testing of troponin may improve timely diagnosis of acute coronary syndrome. Aim To examine existing evidence on the effectiveness of point-of-care testing of troponin for acute coronary syndrome management in the emergency department. Methods A systematic review of randomised controlled trials was conducted across databases, and grey literature. Results No study evaluated adherence to acute coronary syndrome management guidelines. One of the five studies that assessed length of stay showed a statistically significant reduction (P=0.035). Two of the three studies that measured time to disposition in emergency department demonstrated statistically significant effects (P=0.04 vs P=0.05) favouring point-of-care testing of troponin. One study demonstrated statistically significant effects on successful discharge to home from emergency department (P=0.001). No significant effects were reported for mortality or accuracy. Conclusion Point-of-care testing of troponin can significantly reduce time to disposition in emergency department and successful discharge home. Translation of this evidence into clinical practice is recommended.
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Du et al. (2020) conducted a systematic review in acute coronary syndrome. Point-of-care testing of cardiac troponin was evaluated on length of stay, time to disposition, successful discharge to home, mortality, and accuracy. Point-of-care testing of cardiac troponin reduced emergency department length of stay and time to disposition, and increased successful discharge home.
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