All Journals from Deirdre O’Riordan
Aim: To investigate the clinical predictive value of troponin (hscTnT) and blood culture testing.
Methods: We examined all medical admissions from 2011-2020. Prediction of 30-day in-hospital mortality, dependent on blood culture and hscTnT requests/results, was evaluated using multiple variable logistic regression. Length of stay was related to utilization of procedures/services with truncated Poisson regression.
Results: There were 77,566 admissions in 42,325 patients. With both blood cultures and hscTnT requested, 30-day in-hospital mortality increased to 20.9% (95%CI: 19.7, 22.1) vs 8.9% (95%CI: 8.5, 9.4) for blood cultures alone and 2.3% (95%CI: 2.2, 2.4) with neither. Blood culture 3.93 (95%CI: 3.50, 4.42) or hsTnT requests 4.58 (95%CI: 4.10, 5.14) were prognostic.
Conclusion: Blood culture and hscTnT requests and results predict worse outcomes.
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Background: An ‘unwell’ patient is a common presentation.
Methods: We studied all ED ‘unwell’ admissions over 6 years, assessing factors influencing mortality with logistic regression.
Results: From 49,965 admissions, the ED diagnosis was ‘unwell’ in 3650 (7.3%). ‘Unwell’ presentations were older and had longer length of stay. Mortality was not different 4.2% vs 4.6 % (p=0.28). Respiratory patients and those >=70 years had increased mortality, 8.3% (95%CI: 5.9%, 10.6%) and 7.1% (5.7%, 8.4%) respectively. Being unwell predicted a better outcome - univariate OR 0.35 (95%CI: 0.24, 0.52), multivariable OR 0.68 (95%CI: 0.44, 1.03).
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