The Evaluation Of Laboratory Efficiency In The Emergency Department By TAT Values In Shanghai

Purpose: To analyse the Turn-Around Time (TAT) of biomarkers of myocardial injuryin patients visiting the Emergency Department (ED) in Shanghai Hospitals, and todiscuss the possibilities to improve the diagnostic efficiency and alleviateovercrowding emergency.Methods: This study is a randomized, multi-central and prospective analysis thatenrolled seventeen tier II and tier III hospitals. Patients visiting ED with chest painwere recruited. Their TAT values were documented and analysed.Results: All911cases with chest pain in seventeen hospitals (ten tier II and seven tierIII hospitals) were recruited in this analysis. Median value of serum c-TNT TAT in tierII hospital was shorter than in tier III hospital, with61minutes (46-76min) versus64minutes (46-84min)（p<0.05）. Median value of serum c-TNT TAT was60minutes(42-83min) in central laboratory, which was shorter compared with65minutes(53-85min) in emergency laboratory（P<0.05）. Meanwhile,61%(306cases) patientsvisiting tier III hospital were diagnosed with acute myocardial infarction, and28%(41cases) were diagnosed with heart failure. The diagnostic rates in tier II hospitalwere46%(187cases) and41%(58cases), respectively. Median value of c-TNT TATmeasured with POCT was47minutes (39-55.5min).Conclusion: In our study, we revealed that the TAT value of myocardial infarction biomarkers tested in tier II hospital was similar, if not shorter, than in tier III hospital.Therefore, our study provided evidence for encouraging patients to consult regionalhospitals rather than tier III hospitals. Our study also showed that diagnosticefficiency was lower in emergency laboratory than in central laboratory. So thediagnostic efficiency needs to be improved. The POCT method could be used in EDto improve TAT value and ameliorate diagnostic efficiency of patients with chest pain.