Short‐term risk of adverse outcome is significantly higher in patients returning an abnormal troponin result when tested in the emergency department
Bibliographic record
Abstract
OBJECTIVE: Describe short-term mortality and hospitalization outcomes in patients undergoing troponin testing in Western Australia tertiary public hospital ED. METHODS: Retrospective cohort study of adults presenting to urban tertiary ED between July 2000 and December 2004, and undergoing troponin inhibitory or tropomyosin binding testing. Patient data relating to ED attendance, troponins, hospitalization and death were linked using probabilistic data linkage. Troponin results were dichotomized (normal/abnormal) according to hospitals' cut-offs across various time periods. Presentations undergoing ED troponin testing, provided that it was not within 28 days of a previous discharge involving ED troponin testing, met study inclusion criteria. Logistical regression analyses quantified risk of subsequent hospitalization and death. RESULTS: A total of 119 646 troponin tests were performed during 83 635 ED presentations involving 54 214 patients. For the 73 965 ED presentations meeting the study criteria, 6779 (9.2%) recorded an abnormal peak troponin level and 168 (2.5%) of these presentations were discharged directly from ED. After adjusting for covariates, those discharged directly from ED with abnormal troponin results were significantly more likely to die within 2 days (OR 60.4, 95% CI 31.9-114.2), 7 days (OR 31.2, 95% CI 17.9-54.3) and 28 days (OR 19.4, 95% CI 12.5-30.1) of discharge, compared with those with normal troponin results. Adjusted odds of subsequent hospital admission within 28 days following discharge from ED were 3.3 (95% CI 2.4-4.5) times greater for presentations with abnormal versus normal troponin results. CONCLUSION: An abnormal ED troponin result appears to be associated with increased risk of subsequent hospitalization and death within 28 days of discharge.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".