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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 orcid 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
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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
  • pmid:31277048
  • scopus:85068193697
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
2024-04-16 16:09:39
@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}},
  keywords     = {{Cardiac arrest; Critical care; Intensive care unit; Mortality; Sepsis; Troponin}},
  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}},
}