Il tempo di risposta del Laboratorio (turnaround time, TAT) per la troponina (cTn). Raccomandazione del GdS MM SIPMeL View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-06-20

AUTHORS

Daniela Rubin, Matteo Cassin, Margherita Morandini, Piero Cappelletti, Francesca Veneziani, Maria Aurora Burgio, Massimiliano Manno, Elisabetta Stenner, Marco Moretti, Giulio Marino, Dina Di Maria, Deborah Mazzei, Lucia Malloggi, Alessio Gamboni, Gianni Antonio Galli

ABSTRACT

Background.The timeliness, measured as turnaround time (TAT), of troponin (cTn) is a critical factor in the diagnosis and rule in / rule out of Emergency Department (ED) patients suspected of acute coronary syndromes (ACS). Nevertheless, in the past the required serial sampling could diminish the need for a very rapid TAT on any single sample.Methods.A bibliographic research was conducted on PubMed and several institutional and Scientific Societies websites for clinical and laboratory guidelines (GLs) with a recommended cTn TAT and for evidences of effects of TAT on clinical and/or organizational outcomes of ED patients with suspected NSTEMI (non-ST elevation myocardial infarction), produced in the last 5 years.Results.Three of eight clinical GLs and five of five Laboratory GLs recommend a cTn TAT ≤ 1 h, but this quality goal is not evidence-based: TAT has a clear effect only on ED length-of-stay (LOS), that could affect patients’ outcomes. Nevertheless, the use of high-sensitivity troponin (hs-cTn) quick algorithms at 1 h, 30 min or at presentation (T0) and accelerated diagnostic pathways that combine hs-cTn, ECG and risk scores (ADP) allow a rapid and safe rule in / rule out for over two/thirds in 1 hour and for over one/third at T0 of ED patients suspected of NSTEMI (NPV for MACE 98.7–100% and 95.5–100%, respectively). The definition of cTn TAT and of its beginning (order, blood collection, laboratory receipt) is still uncertain.Conclusions.The hs-cTn TAT should be ≤1 h or less, for an effective use in new algorithms at 1 h or T0 and in new ADPs, suggested by clinical GLs and literature evidences. The TAT should measure the time from blood collection to the availability of results. More... »

PAGES

105-121

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http://scigraph.springernature.com/pub.10.1007/s13631-018-0192-z

DOI

http://dx.doi.org/10.1007/s13631-018-0192-z

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https://app.dimensions.ai/details/publication/pub.1105011697


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