[Elevated troponin I level in patients discharged home directly from the emergency department: prognostic value for 1-year mortality].

Objectives: To study the prognostic role of elevated troponin I levels in patients discharged home directly from a hospital emergency department.

Material And Methods: Observational study of a retrospective cohort of all patients attended for any emergency for whom troponin I tests were ordered and who were discharged home directly from our hospital emergency department between January and December 2012. We collected demographic information, medical histories, symptoms related to the acute coronary event, and diagnosis on discharge. The main outcome was all-cause mortality in the year following discharge.

Results: A total of 1381 patients discharged home directly from the emergency department were studied; 1192 (86.3%) had normal troponin I results and 189 (13.7%) had elevated levels. On multivariate analysis, troponin I elevation emerged as an independent risk factor for death within a year of discharge (hazard ratio, 2.41; 95% CI, 1.40-4.22; P<.01).

Conclusion: A raised troponin I level is an independent predictor of 1-year mortality in patients for whom this test is ordered at least once and who are discharged home directly from a hospital emergency service.