[French laboratories turn-around-time (TAT) for troponin measurement for Emergency Departments: the EN-TRO-PRISE survey]

Abstract

The latest international recommendations advocate for the measurement of cardiac troponin (cTn) in the context of acute coronary syndrome (ACS) with a result turnaround time of less than 1 or 2 hours. To establish a national overview of organizational practices and turnaround times for these measurements. Two surveys targeting emergency physicians and biologists described the qualitative and quantitative organizational data of cTn measurement. 27 hospitals with an annual number of visits totaling 35,000 [28,700-55,500], with 8.5% of patients presenting with chest pain and 0.9% with ACS. The satisfaction rate of emergency physicians regarding the turnaround time is 27%, and 50% wish to see it reduced. Quantitatively, 74,112 troponin requests were analyzed, 33% of which were performed during on-call periods. Cardiac cTnT represents 70% of the measurements, and 98 % of the methods are highly sensitive. The median pre-registration time is 19 minutes [10-35], laboratory-processing time is 55 minutes [42-82], and overall turnaround time is 81 minutes [60-121]. The turnaround time is shorter when there is a connected prescription or an expert system for biological validation (p < 0.0001). The turnaround times for troponin results are on average >1 hour. For most laboratories (83 %), the turnaround time is in line with European recommendations allowing the application of an H0-H2 algorithm.

Keywords: cardiac troponin; chest pain; emergency department; turn-around-time.