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A descriptive study of the use of troponin I testing at a Cape Town district hospital
Introduction: Troponin I tests have been shown to be accurate and are relied upon to assist in making critical decisions regarding patient care in patients presenting with chest pain. The tests are expensive, however, and so their rational use becomes extremely important in a budget-constrained publ...
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| Format: | Thesis |
| Language: | English |
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Division of General Surgery
2020
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| _version_ | 1867613199249965056 |
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| access_status_str | Open Access |
| author | Gibson, Joshua Glynn |
| author2 | Malan, Jacques |
| author_browse | Gibson, Joshua Glynn Malan, Jacques |
| author_facet | Malan, Jacques Gibson, Joshua Glynn |
| author_sort | Gibson, Joshua Glynn |
| collection | Thesis |
| description | Introduction: Troponin I tests have been shown to be accurate and are relied upon to assist in making critical decisions regarding patient care in patients presenting with chest pain. The tests are expensive, however, and so their rational use becomes extremely important in a budget-constrained public health sector. The aim of this study was to describe how Troponin I tests are used throughout Victoria Hospital, by a range of requesting clinicians, working in different specialties. Methods A cross-sectional, prospective design was employed, using multiple data sources. We collected a consecutive sample over a three-month period from Victoria hospital’s Emergency Centre using a dedicated data collection tool connected to use of the point-of-care troponin I test. We supplemented this prospective sample with outcome data, using the hospital’s electronic admission record. Results Three hundred and sixteen patient entries were included in the final results. The majority of Troponin tests were negative (70%). Discharge directly from Emergency Centre was 10% in Troponin I positive patients, 37,5% in Equivocal Troponin patients, and 65% in Troponin negative patients. Furthermore, patients were twice as likely to be transferred to a tertiary facility if their Troponin was positive (24%), compared to equivocal (10.4%) or negative (12%). Discussion Chest pain was the most common presenting complaint, with Acute Coronary Syndrome being the most common working diagnosis. The clinical management of patients varied considerably when comparing their Troponin I result. Troponin I appears to be used as an effective rule-out tool in the decision-making pathway. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31227 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:20.328Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31227 A descriptive study of the use of troponin I testing at a Cape Town district hospital Gibson, Joshua Glynn Malan, Jacques Bruijns, Stevan surgery Introduction: Troponin I tests have been shown to be accurate and are relied upon to assist in making critical decisions regarding patient care in patients presenting with chest pain. The tests are expensive, however, and so their rational use becomes extremely important in a budget-constrained public health sector. The aim of this study was to describe how Troponin I tests are used throughout Victoria Hospital, by a range of requesting clinicians, working in different specialties. Methods A cross-sectional, prospective design was employed, using multiple data sources. We collected a consecutive sample over a three-month period from Victoria hospital’s Emergency Centre using a dedicated data collection tool connected to use of the point-of-care troponin I test. We supplemented this prospective sample with outcome data, using the hospital’s electronic admission record. Results Three hundred and sixteen patient entries were included in the final results. The majority of Troponin tests were negative (70%). Discharge directly from Emergency Centre was 10% in Troponin I positive patients, 37,5% in Equivocal Troponin patients, and 65% in Troponin negative patients. Furthermore, patients were twice as likely to be transferred to a tertiary facility if their Troponin was positive (24%), compared to equivocal (10.4%) or negative (12%). Discussion Chest pain was the most common presenting complaint, with Acute Coronary Syndrome being the most common working diagnosis. The clinical management of patients varied considerably when comparing their Troponin I result. Troponin I appears to be used as an effective rule-out tool in the decision-making pathway. 2020-02-21T13:25:19Z 2020-02-21T13:25:19Z 2018 2020-02-21T07:40:17Z Master Thesis Masters MMed http://hdl.handle.net/11427/31227 eng application/pdf Division of General Surgery Faculty of Health Sciences |
| spellingShingle | surgery Gibson, Joshua Glynn A descriptive study of the use of troponin I testing at a Cape Town district hospital |
| thesis_degree_str | Master's |
| title | A descriptive study of the use of troponin I testing at a Cape Town district hospital |
| title_full | A descriptive study of the use of troponin I testing at a Cape Town district hospital |
| title_fullStr | A descriptive study of the use of troponin I testing at a Cape Town district hospital |
| title_full_unstemmed | A descriptive study of the use of troponin I testing at a Cape Town district hospital |
| title_short | A descriptive study of the use of troponin I testing at a Cape Town district hospital |
| title_sort | descriptive study of the use of troponin i testing at a cape town district hospital |
| topic | surgery |
| url | http://hdl.handle.net/11427/31227 |
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