Troponin Assays May Lower Hospital Costs

Calculations have demonstrated that the use of troponin I testing to help diagnose myocardial infarction (MI) and cardiac muscle damage may not only optimize clinical outcomes but also reduce the annual length-of-stay of patients in hospitals by more than 8%, while lowering associated annual costs in the cardiac care unit and chest pain unit by more than 7%.

For a typical emergency department (ED) and hospital critical care unit (CCU), use of troponin I testing could generate savings close to US$1 million per year, according to Robert Parson, a clinical biostatistician for Beckman Coulter, Inc. (Fullerton, CA, USA), which markets the AccuTnI troponin I assay. Parson presented his conclusions at the annual meeting of the American Association for Clinical Chemistry (AACC) in Chicago, IL (USA).

Parson cites two major factors that have significant financial implications for hospital EDs when diagnosing heart disease. These two factors are unnecessary hospital admissions and inappropriate ED discharges. The first factor is caused by patients who are admitted to the hospital with suspected cardiac disease but in 50% of cases are ultimately found to have noncardiac, nonlife-threatening causes and are discharged. The second factor is caused by patients discharged as noncardiac cases but who were actually misdiagnosed, having had an acute myocardial infarction (AMI). Inappropriate discharge of AMI patients is the leading cause of malpractice lawsuits against ED doctors.

EDs that can identify cardiac patients quickly and accurately are therefore better able to control costs, improve patient care, optimize clinical outcomes, and use resources more efficiently. Studies show that the cardiac troponin markers are among the most effective tools to aid in the diagnosis of AMI and cardiac muscle damage. Thus, determination of troponin I levels could shorten length-of-stay and reduce admissions of noncardiac chest pain patients to CCUs.

"Because of their clinical sensitivity and specificity, the troponin I assays are the method-of-choice for identifying chest-pain patients with myocardial injury, MI, and ischemia,” said Parsons.





Related Links:
Beckman Coulter