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Journals / Meandros Medical And Dental Journal / 2026 / Volume: 27 Issue: 3

Short- and Mid-Term Outcomes in Emergency Department Patients Discharged with Elevated High-Sensitivity Troponin I: A Retrospective Cohort Study

Kürşat Kaan Kerimoğlu(Alsancak Nevvar-Salih İşgören Devlet Hastanesi)0009-0002-7519-5546
Pages
—
Publication Date
2026-09-24
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Even mild elevations in hs-cTnI may have prognostic significance, underscoring the importance of implementing structured discharge procedures and follow-up protocols for this patient population.

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Objective & Hypothesis:Purpose: This study aimed to evaluate the short- and mid-term outcomes of patients discharged from the emergency department (ED) with elevated high-sensitivity cardiac troponin I (hs-cTnI) levels, in the absence of standardized management protocols.
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Key Findings & Data:Materials and Methods: In this retrospective case-control study, the outcomes of adult patients discharged from the ED between January 2023 and December 2024 were compared.
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Conclusion & Impact:Even mild elevations in hs-cTnI may have prognostic significance, underscoring the importance of implementing structured discharge procedures and follow-up protocols for this patient population.
🔬Design:Research Article
📍Scope:2023 Verileri
⚙️Variables:High-sensitivity cardiac troponin I · short-term mortality · risk stratification

Abstract

Purpose: This study aimed to evaluate the short- and mid-term outcomes of patients discharged from the emergency department (ED) with elevated high-sensitivity cardiac troponin I (hs-cTnI) levels, in the absence of standardized management protocols. Materials and Methods: In this retrospective case-control study, the outcomes of adult patients discharged from the ED between January 2023 and December 2024 were compared. Patients with elevated hs-cTnI levels (>15 ng/L) were matched with controls possessing normal levels. The primary outcomes assessed included all-cause mortality at 30 and 90 days and healthcare revisits. Survival and prognostic analyses were conducted utilizing Kaplan-Meier and ROC methods. Results: Among 1,144 discharged patients, 568 had elevated hs-cTnI levels. The 90-day mortality rate was significantly higher in the case group than in the control group (7.0% vs 2.1%; OR = 3.56; p <0.001). Additionally, the rates of 30- and 90-day revisits were elevated in the group with increased hs-cTnI (16.0% and 21.7%, respectively). Kaplan–Meier analysis demonstrated significantly reduced 90-day survival among patients with elevated hs-cTnI levels (mean survival of 87.5 days versus 89.1 days; log-rank p <0.001). ROC analysis indicated that a peak hs-cTnI level exceeding 20 ng/L predicted 90-day mortality with an AUC of 0.626 (95% CI: 0.545–0.706), thereby establishing a clinically meaningful prognostic threshold. Conclusion: Patients discharged from the ED with elevated hs-cTnI levels exhibited increased mid-term mortality and revisit rates. Even mild elevations in hs-cTnI may have prognostic significance, underscoring the importance of implementing structured discharge procedures and follow-up protocols for this patient population.

Özet

Purpose: This study aimed to evaluate the short- and mid-term outcomes of patients discharged from the emergency department (ED) with elevated high-sensitivity cardiac troponin I (hs-cTnI) levels, in the absence of standardized management protocols. Materials and Methods: In this retrospective case-control study, the outcomes of adult patients discharged from the ED between January 2023 and December 2024 were compared. Patients with elevated hs-cTnI levels (>15 ng/L) were matched with controls possessing normal levels. The primary outcomes assessed included all-cause mortality at 30 and 90 days and healthcare revisits. Survival and prognostic analyses were conducted utilizing Kaplan-Meier and ROC methods. Results: Among 1,144 discharged patients, 568 had elevated hs-cTnI levels. The 90-day mortality rate was significantly higher in the case group than in the control group (7.0% vs 2.1%; OR = 3.56; p <0.001). Additionally, the rates of 30- and 90-day revisits were elevated in the group with increased hs-cTnI (16.0% and 21.7%, respectively). Kaplan–Meier analysis demonstrated significantly reduced 90-day survival among patients with elevated hs-cTnI levels (mean survival of 87.5 days versus 89.1 days; log-rank p <0.001). ROC analysis indicated that a peak hs-cTnI level exceeding 20 ng/L predicted 90-day mortality with an AUC of 0.626 (95% CI: 0.545–0.706), thereby establishing a clinically meaningful prognostic threshold. Conclusion: Patients discharged from the ED with elevated hs-cTnI levels exhibited increased mid-term mortality and revisit rates. Even mild elevations in hs-cTnI may have prognostic significance, underscoring the importance of implementing structured discharge procedures and follow-up protocols for this patient population.

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Cite This Article

Kerimoğlu, K. K. (2026). Short- and Mid-Term Outcomes in Emergency Department Patients Discharged with Elevated High-Sensitivity Troponin I: A Retrospective Cohort Study. Meandros Medical And Dental Journal, Volume: 27 Issue: 3. https://doi.org/10.69601/meandrosmdj.1859647

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