Prehospital Risk Stratification with Troponin Point-of-Care Testing

Troponin point-of-care assays can be used by paramedics to stratify risk in patients with chest pain. In this Australian study, researchers conducted a cost-minimization modeling study of three different strategies: (1) current care, (2) paramedic risk stratification with prehospital troponin testing, and (3) prehospital troponin testing with discharge to a virtual emergency department (ED) for low-risk patients.

Using data for 188,000 patients (mean age, 62) with chest pain who were transported by ambulance, costs were lower with prehospital troponin testing than with current care (cost savings, AU$6.45 million). Costs were even lower when testing was combined with discharge to a virtual ED for low-risk patients (cost savings, $42.8 million…