• Journal of critical care · Oct 2019

    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.

    • Peder Andersson and Attila Frigyesi.
    • Department of Clinical Sciences, Section for Anaesthesiology and Intensive Care, Lund University, SE-22185 Lund, Sweden; Department of Intensive and Perioperative Care, Skåne University Hospital, SE-22185 Lund, Sweden. Electronic address: peder.andersson@med.lu.se.
    • J Crit Care. 2019 Oct 1; 53: 218-222.

    PurposeElevated 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 MethodsWe 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.ResultsOf 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%.ConclusionAddition 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.Copyright © 2019 Elsevier Inc. All rights reserved.

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