Troponin testing: an audit in three metropolitan hospitals.
OBJECTIVE
To audit the appropriateness of use of a troponin I assay in three hospitals.


METHODS
Cross-sectional survey of use of a troponin assay.


METHODS
Three hospitals in Melbourne, Victoria, each with an emergency department and a coronary care unit.


METHODS
Patients for whom a troponin I assay was requested between 1 and 7 May 2002, 27-42 months after introduction of the assay.


METHODS
User-focused dissemination of relevant information, including protocols for use, from opinion leaders when the assay was introduced; continuous reinforcement of information in pathology reports.


METHODS
Adherence to protocol for assay use.


RESULTS
Troponin assays were requested for 333 patients during 351 symptom episodes. A single assay was used in 194 symptom episodes (55%), and serial assays in 157 (45%); proportions were statistically indistinguishable across all three hospitals (chi(2); P = 0.71). Of the 194 single assays, 13 (7%) diagnosed a myocardial infarction. Serial troponin testing in all three hospitals followed the suggested protocol, with mean time between serial assays being more than 6 hours at all hospitals.


CONCLUSIONS
Adherence to the protocol for serial troponin assay intervals was adequate, but single troponin assays were used extensively and probably inappropriately.
Davey
Richard X
RX
Pathology Department, Western Hospital, Footscray, VIC 3011. richard.davey@wh.org.au
D001681:Biological Assay / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013997:Time Factors; D019210:Troponin I / Q000097:blood*; D014739:Victoria
D019210:Troponin I