الملخص الإنجليزي
Objectives:The aim of this study was to examine patterns of troponin testing in the emergency
department of a large tertiary care hospital in Oman and to determine its effect on patient management, including
length of hospital stay (LOS). Methods: This retrospective study analysed the medical records of all adult patients
undergoing troponin testing in the emergency department of the Sultan Qaboos University Hospital, Muscat,
Oman, during the month of July 2015. Patients who presented with an ST-elevation myocardial infarction were
excluded.
Results: A total of 4,845 patients attended the emergency department during the study period; of
these, troponin tests were ordered for 588 patients. The majority of the patients had negative troponin test results
(81.3%). Chest pain, palpitations and breathlessness were the most common presenting complaints for those with
positive troponin results. However, 41.8% of patients did not have any cardiac symptoms. Individuals with positive
troponin tests had a significantly longer LOS compared to those with negative tests (mean: three versus one day;
P = 0.001). In total, only 28.2% of those with positive troponin test results had final diagnoses associated with
a cardiac condition, such as heart failure, an acute coronary syndrome (ACS), atrial fibrillation or other types
of arrhythmia. Conclusion: A positive troponin test was associated with increased LOS; however, only a small
proportion of these patients had a final diagnosis associated with a cardiac condition. Guidelines should be provided
to ensure that troponin testing is performed only in cases where an ACS is suspected.
