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High-sensitivity troponin T is an important independent predictor in addition to the Simplified Acute Physiology Score for short-term ICU mortality, particularly in patients with sepsis

Andersson, Peder LU and Frigyesi, Attila LU (2019) In Journal of Critical Care 53. p.218-222
Abstract

Purpose: Elevated cardiac troponin levels have been shown to be associated with a poor prognosis under some intensive care conditions. This study investigated whether inclusion of high-sensitivity troponin T (hsTnT) increased the prognostic accuracy of the Simplified Acute Physiology Score (SAPS 3) for general intensive care unit (ICU) patients, cardiac arrest patients, or patients with a non-cardiac arrest diagnosis. Materials and methods: We performed a single-center cohort study of ICU patients with an hsTnT measurement on ICU admission at a tertiary university hospital between February 2010 and June 2017. Results: Of 4185 first-time admissions, 856 patients (20.5%) had hsTnT evaluated at ICU admission. Factoring in ICU admission... (More)

Purpose: Elevated cardiac troponin levels have been shown to be associated with a poor prognosis under some intensive care conditions. This study investigated whether inclusion of high-sensitivity troponin T (hsTnT) increased the prognostic accuracy of the Simplified Acute Physiology Score (SAPS 3) for general intensive care unit (ICU) patients, cardiac arrest patients, or patients with a non-cardiac arrest diagnosis. Materials and methods: We performed a single-center cohort study of ICU patients with an hsTnT measurement on ICU admission at a tertiary university hospital between February 2010 and June 2017. Results: Of 4185 first-time admissions, 856 patients (20.5%) had hsTnT evaluated at ICU admission. Factoring in ICU admission hsTnT values increased the ability of SAPS 3 to accurately predict 30-day mortality (odds ratio 1.27, 95% confidence interval: 1.15–1.41, p < 0.001). Elevated hsTnT levels were not independently associated with 30-day mortality in cardiac arrest patients. In sepsis patients, hsTnT evaluation in addition to SAPS 3 evaluation improved the area under the receiver operating characteristic curve by >10%. Conclusion: Addition of hsTnT evaluation to SAPS 3 enhances the predictive capability of this model in relation to mortality. In sepsis, the hsTnT level may be an important prognostic marker.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac arrest, Critical care, Intensive care unit, Mortality, Sepsis, Troponin
in
Journal of Critical Care
volume
53
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:85068193697
  • pmid:31277048
ISSN
0883-9441
DOI
10.1016/j.jcrc.2019.06.018
language
English
LU publication?
yes
id
416bbc52-0abc-4d53-8999-796f53fc6e81
date added to LUP
2019-07-09 08:48:49
date last changed
2020-01-13 02:12:49
@article{416bbc52-0abc-4d53-8999-796f53fc6e81,
  abstract     = {<p>Purpose: Elevated cardiac troponin levels have been shown to be associated with a poor prognosis under some intensive care conditions. This study investigated whether inclusion of high-sensitivity troponin T (hsTnT) increased the prognostic accuracy of the Simplified Acute Physiology Score (SAPS 3) for general intensive care unit (ICU) patients, cardiac arrest patients, or patients with a non-cardiac arrest diagnosis. Materials and methods: We performed a single-center cohort study of ICU patients with an hsTnT measurement on ICU admission at a tertiary university hospital between February 2010 and June 2017. Results: Of 4185 first-time admissions, 856 patients (20.5%) had hsTnT evaluated at ICU admission. Factoring in ICU admission hsTnT values increased the ability of SAPS 3 to accurately predict 30-day mortality (odds ratio 1.27, 95% confidence interval: 1.15–1.41, p &lt; 0.001). Elevated hsTnT levels were not independently associated with 30-day mortality in cardiac arrest patients. In sepsis patients, hsTnT evaluation in addition to SAPS 3 evaluation improved the area under the receiver operating characteristic curve by &gt;10%. Conclusion: Addition of hsTnT evaluation to SAPS 3 enhances the predictive capability of this model in relation to mortality. In sepsis, the hsTnT level may be an important prognostic marker.</p>},
  author       = {Andersson, Peder and Frigyesi, Attila},
  issn         = {0883-9441},
  language     = {eng},
  pages        = {218--222},
  publisher    = {Elsevier},
  series       = {Journal of Critical Care},
  title        = {High-sensitivity troponin T is an important independent predictor in addition to the Simplified Acute Physiology Score for short-term ICU mortality, particularly in patients with sepsis},
  url          = {http://dx.doi.org/10.1016/j.jcrc.2019.06.018},
  doi          = {10.1016/j.jcrc.2019.06.018},
  volume       = {53},
  year         = {2019},
}