Junior doctors will be taking part in planned industrial action from Friday 11 August - Tuesday 15 August. We are expecting health services to be under extreme pressure so please be prepared for longer waiting times. Alternatively, visit NHS 111 online.
Trade unions representing some NHS staff are in dispute with the Government over the 2022/23 pay award. A number of the unions have balloted their NHS members to take part in industrial action. As a result members of the following unions have advised of plans to take strike action on the dates listed below:
12 August – all day, BMA and HCSA Junior Doctors and BDA hospital dental trainees* out on strike across England
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Association between troponin level and medium-term mortality in 20 000 hospital patientsIntroduction Cardiac troponin (cTn) concentrations above the manufacturer recommended upper limit of normal (ULN) are frequently seen in hospital patients without a clinical presentation consistent with type 1 myocardial infarction, and the significance of this is uncertain. The aim of this study was to assess the relationship between medium-term mortality and cTn concentration in a large consecutive hospital population, regardless of whether there was a clinical indication for performing the test. Method This prospective observational study included 20 000 consecutive in-hospital and outpatient patients who had a blood test for any reason at a large teaching hospital, and in whom a hs-cTnI assay was measured, regardless of the original clinical indication. Mortality was obtained via NHS Digital. Results A total of 20 000 patients were included in the analysis and 18 282 of these (91.4%) did not have a clinical indication for cardiac troponin I (cTnI) testing. Overall, 2825 (14.1%) patients died at a median of 809 days. The mortality was significantly higher if the cTnI concentration was above the ULN (45.3% vs 12.3% p|0.001 log rank). Multivariable Cox analysis demonstrated that the log10 cTnI concentration was independently associated with mortality (HR 1.76 (95% CI 1.65 to 1.88)). Landmark analysis, excluding deaths within 30 days, showed the relationship between cTnI concentration and mortality persisted. Conclusion In a large, unselected hospital population, in 91.4% of whom there was no clinical indication for testing, cTnI concentration was independently associated with medium-term cardiovascular and non-cardiovascular mortality in the statistical model tested. No data are available. The nature of the data sharing agreement with NHS Digital prevents sharing of these data.
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