In this small single institution study of 159 bacteremic patients, all of which had troponin I sent, 43% were elevated (abstract). Most were minor elevations (96% < 1mcg/L). Not surprisingly, independent risk factors for troponin elevations included renal insufficiency, higher WBC, and septic shock. Troponin elevations were not significantly associated with EKG changes (although not performed in all patients), and did not independently predict mortality. For bacteremic patients, if you check troponin, there is about a coin-toss chance it will be elevated, but given the lack of association with EKG changes or mortality, there is no clear benefit of routinely checking it in the first place.
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]
By reading the headlines recently, practitioners would not know if they saved or tanked the healthcare system. One day disaster looms, the next we have moderated growth and business can continue as usual (and by business, I mean doing the correct things correctly). A new study, along with some recent data, helps shed some light […]