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dc.contributor.author
Martín Rodríguez, Francisco  
dc.contributor.author
Sanz García, Ancor  
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Ortega, Guillermo José  
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Delgado Benito, Juan F.  
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del Pozo Vegas, Carlos  
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Ortega, Guillermo José  
dc.contributor.author
Martín Herrero, Francisco  
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Martín Conty, José Luis  
dc.contributor.author
López Izquierdo, Raúl  
dc.date.available
2022-08-16T13:23:05Z  
dc.date.issued
2021-05  
dc.identifier.citation
Martín Rodríguez, Francisco; Sanz García, Ancor; Ortega, Guillermo José; Delgado Benito, Juan F.; del Pozo Vegas, Carlos; et al.; Prehospital troponin as a predictor of early clinical deterioration; Wiley Blackwell Publishing, Inc; European Journal of Clinical Investigation; 51; 11; 5-2021; 1-10  
dc.identifier.issn
0014-2972  
dc.identifier.uri
http://hdl.handle.net/11336/165592  
dc.description.abstract
Background and Objectives: Elevated troponin T (cTnT) values are associated with comorbidities and early mortality, in both cardiovascular and noncardiovascular diseases. The objective of this study is to evaluate the prognostic accuracy of the sole utilization of prehospital point-of-care cardiac troponin T to identify the risk of early in-hospital deterioration, including mortality within 28 days. Methods: We conducted a prospective, multicentric, controlled, ambulance-based, observational study in adults with acute diseases transferred with high priority by ambulance to emergency departments, between 1 January and 30 September 2020. Patients with hospital diagnosis of acute coronary syndrome were excluded. The discriminative power of the predictive cTnT was assessed through a discrimination model trained using a derivation cohort and evaluated by the area under the curve of the receiver operating characteristic on a validation cohort. Results: A total of 848 patients were included in our study. The median age was 68 years (25th-75th percentiles: 50-81 years), and 385 (45.4%) were women. The mortality rate within 28 days was 12.4% (156 cases). The predictive ability of cTnT to predict mortality presented an area under the curve of 0.903 (95% CI: 0.85-0.954; P <.001). Risk stratification was performed, resulting in three categories with the following optimal cTnT cut-off points: high risk greater than or equal to 100, intermediate risk 40-100 and low risk less than 40 ng/L. In the high-risk group, the mortality rate was 61.7%, and on the contrary, the low-risk group presented a mortality of 2.3%. Conclusions: The implementation of a routine determination of cTnT on the ambulance in patients transferred with high priority to the emergency department can help to stratify the risk of these patients and to detect unknown early clinical deterioration.  
dc.format
application/pdf  
dc.language.iso
eng  
dc.publisher
Wiley Blackwell Publishing, Inc  
dc.rights
info:eu-repo/semantics/openAccess  
dc.rights.uri
https://creativecommons.org/licenses/by-nc/2.5/ar/  
dc.subject
AMBULANCE  
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BIOMARKERS  
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CLINICAL PREDICTION RULE  
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MEDICAL DECISION-MAKING  
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PREHOSPITAL EMERGENCY CARE  
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Otras Medicina Clínica  
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Medicina Clínica  
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CIENCIAS MÉDICAS Y DE LA SALUD  
dc.title
Prehospital troponin as a predictor of early clinical deterioration  
dc.type
info:eu-repo/semantics/article  
dc.type
info:ar-repo/semantics/artículo  
dc.type
info:eu-repo/semantics/publishedVersion  
dc.date.updated
2022-08-12T10:11:10Z  
dc.journal.volume
51  
dc.journal.number
11  
dc.journal.pagination
1-10  
dc.journal.pais
Reino Unido  
dc.journal.ciudad
Londres  
dc.description.fil
Fil: Martín Rodríguez, Francisco. Universidad de Valladolid; España  
dc.description.fil
Fil: Sanz García, Ancor. Universidad Autonoma de Madrid. Hospital Universitario de la Princesa; España  
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Fil: Ortega, Guillermo José. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Autonoma de Madrid. Hospital Universitario de la Princesa; España  
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Fil: Delgado Benito, Juan F.. Universidad de Valladolid; España  
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Fil: del Pozo Vegas, Carlos. Universidad de Valladolid; España  
dc.description.fil
Fil: Ortega, Guillermo José. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina  
dc.description.fil
Fil: Martín Herrero, Francisco. No especifíca;  
dc.description.fil
Fil: Martín Conty, José Luis. Universidad de Castilla-La Mancha; España  
dc.description.fil
Fil: López Izquierdo, Raúl. Universidad de Valladolid; España  
dc.journal.title
European Journal of Clinical Investigation  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1111/eci.13591