Acil serviste troponin yüksekliği saptanan hastaların epidemiyolojik analizi
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Dosyalar
Tarih
2018
Yazarlar
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Troponin T and troponin I from cardiac biomarkers have a high specificity and sensitivity for myocardial injury. However, cardiac troponins are found to be high in many patients presenting with the exception of acute coronary syndrome (ACS). In this study, the epidemiological characteristics of the patients who were admitted to the emergency department with different complaints and were determined the elevation of troponin in biochemical tests were investigated retrospectively. Material and Method: The study was conducted between January 15, 2017 and February 19, 2018 at Necmettin Erbakan University, Meram Faculty of Medicine, Department of Emergency Medicine. Patients aged 18 years and older who had epicrisis information and who were determined to have high troponin levels were included in the study. Patients who arriving as arrest and did not respond to cardiopulmonary resuscitation were not included. Hospital information system and patient files were reviewed patients demographic data, emergency department admission complaints, vital signs, blood tests, comorbidities, echocardiography and electrocardiography findings, emergency department diagnoses and emergency department patient outcome information retrospectively analyzed. Findings: A total of 2006 patients were reviewed for the study. 36.29% (n=728) of the patients were female and 63.71% (n=1278) were male. A total of 16 different complaints were obtained. Chest pain was the highest in the patients admitted to the emergency department (35.1% n=705). Complaints such as shortness of breath (31.5% n=631), general condition disorder (8.8% n=177) and abdominal pain (6.9% n=138) followed chest pain. The highest rate of ECG findings (47.3% n=948) was found in NSR; patients with signs of ischemia 21.9% (n=440) and AF 11.2% (n=224) were detected. All patients were classified according to their diagnosis. A total of 21 diagnoses were identified causing troponin elevation. 28.9% of the patients (n=580) were NSTEMI and 8.6% (n=173) were STEMI. Infection (sepsis / septic shock) was 16.7% (n = 334), HF was 9.1% (n = 182), and COPD was 5.3% (n = 106) among non-ACS diagnoses. 10.5% (n=210) of the patients had idiopathic (the cause of the troponin elevation cannot be determined). The rate of non-ACS diagnoses was found to be high (62.5% n=1253). Results: Although troponins are considered to be the gold standard for ACS diagnosis and risk classification, misinterpretation of high troponin levels may lead to confusion in terms of diagnosis and selection of appropriate treatment options. Although the elevation of troponin is an important indicator of coronary ischemia, it should be noted that some other clinical conditions apart from ACS are frequently associated with infection (sepsis/septic shock), HF, COPD, ARF, CVO, trauma, PE, upper GIS bleeding, it should be kept in mind that unexplained heights (idiopathic) may occur and the elevation of troponin should not always be interpreted in favor of cardiac ischemia..
Açıklama
Anahtar Kelimeler
Troponin, Acute coronary syndrome, Epidemiological analysis, Akut koroner sendrom, Epidemiyolojik analiz
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Başoğul, E. (2018). Acil serviste troponin yüksekliği saptanan hastaların epidemiyolojik analizi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Acil Tıp Anabilim Dalı, Konya.
