Effect of a high sensitivity troponin I and associated diagnostic protocol on emergency department length of stay: a retrospective cohort study

BackgroundThe objective of this study was to assess the introduction a high-sensitivity troponin I (hs-TnI) assay and its associated accelerated protocol on ED length stay (LOS) for patients presenting with chest pain, compared an diagnostic (ADP) using conventional (TnI) testing.MethodsWe conducted retrospective cohort all adults primary complaint pain cardiac origin Canadian Triage Acuity Scale (CTAS) score 2 or 3 between November 8, 2019, 9, 2021, tertiary care urban ED. The outcome LOS. Secondary outcomes included consultation proportions Major Adverse Cardiac Events (MACE) within 30 days index visit.Results2640 were included, 1333 in TnI group 1307 hs-TnI group. Median LOS decreased significantly from 392 minutes 371 (Median difference = 21 minutes; 95% CI: 5.3, 36.7). Consultations admissions not statistically different periods. MACE did change following implementation test (13.6% vs 13.1%; p 0.71).ConclusionsThe CP modest reduction substantial undergoing serial testing. Moreover, strategy safe no increase adverse outcomes.