Near-patient testing for cardiac troponin I to reduce hospital stay in patients presenting with chest pain

Minimising the in-hospital stay of patients with chest pain, within safe limits, is crucial in reducing the cost of health care. The aim of this study was to determine whether the use of near-patient testing for cardiac troponin I could reduce the duration of in-hospital stay for patients presenting with chest pain who were considered to be at low risk of death or myocardial infarction.
This prospective observational study of consecutive patients admitted with chest pain of possible cardiac origin was conducted in a medium-sized district general hospital. A near-patient system for troponin I analysis was compared to traditional laboratory-based troponin I analysis to assess any effect on duration of in-hospital stay in low-risk chest pain patients. Of the 295 patients enrolled in the study, 191 (68.7%) were troponin-negative and were classified as having chest pain of non-cardiac origin or cardiac pain at low risk of major adverse events. The introduction of near-patient testing for cardiac troponin I reduced the mean duration of hospital stay from 30.04 hours to 17.10 hours (p<0.001). At 30-day follow-up no deaths or myocardial infarctions had occurred.