Currently when defining the upper limit of normal (ULN) or 99th percentile of a troponin assay manufacturer's use a healthy population traditionally aged 18-40. The 99th percentile value is the recommended value to use when diagnosing patients with an acute myocardial infarction. With the advent of the new highly sensitive troponin assays it has become clear that many patients have a troponin level above the 99th percentile when they have not suffered a myocardial infarction. We believe part of the problem with interpreting the the troponin values for patients is that the 99th percentile value which determines the ULN has been derived from population that is very different to the hospital population of patients. This study aims to demonstrate what the 99th percentile is for the population of people who use the hospital services who are traditionally older and have more comorbidities when compared to the population traditionally used to define the 99th percentile of a troponin assay. An amendment was approved to follow-up patients' clinical outcomes at 1 year using NHS Digital data.
Study Type
OBSERVATIONAL
Enrollment
20,000
Southampton General Hospital
Southampton, United Kingdom
The 99th percentile for the hospital population.
Distribution and 99th centile for hsTnI BC assay in 20000 consecutive patients having a biochemistry blood test at a large teaching hospital
Time frame: 6 months
The 99th percentile in different variables.
Distribution and 99th centile for hsTnI BC assay in: * Outpatients versus inpatients * Age by quintiles * Female vs male * ITU * General medicine inpatients: chest infection/exacerbation of COPD/PE/DVT/overdose etc * Emergency department, stratified by final diagnosis * General surgery * Major vascular surgery * Major abdominal surgery * Orthopaedic surgery… particularly fractured neck of femur and mortality outcome * Brain surgery * Rheumatoid outpatients according to level of disease activity * Autoimmune disease inpatients and outpatients * Inflammatory bowel disease inpatients \& outpatients * COPD inpatients \& outpatients * Diabetic outpatients and inpatients * Dermatology outpatients according to activity of disease (psoriasis/pemphigus etc)
Time frame: 6 months
The 99th percentile in different variables.
Mortality
Time frame: 12 months
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