Key result
In patients with severe aneurysmal subarachnoid hemorrhage, an hsT level > 22 ng/L at ICU admission was independently associated with poor outcomes at 3 months (OR 2.80; 95% CI 1.18-6.64).
Why the study?
The study was conducted to evaluate the prognostic value of high-sensitivity troponin in severe aneurysmal subarachnoid hemorrhage.
Does high-sensitivity troponin (hsT) level predict poor outcome in patients with severe aneurysmal subarachnoid hemorrhage?
Observational (n=137)
No
Does high-sensitivity troponin (hsT) level predict poor outcome in patients with severe aneurysmal subarachnoid hemorrhage?
Odds Ratio: 2.8 (95% CI 1.18–6.64)
In patients with severe aneurysmal subarachnoid hemorrhage, an elevated high-sensitivity troponin level (>22 ng/L) at ICU admission is independently associated with poor 3-month outcomes.
Elevated hsT may aid prognostication in severe aSAH; hypothesis-generating and requires prospective validation before clinical use.
Objective: To evaluate the prognostic value of high-sensitivity troponin (hsT) in severe aneurysmal subarachnoid hemorrhage (aSAH).Methods: This prospective non-interventional study was performed at a surgical intensive care unit (ICU) from 2012 to 2015. Consecutive patients who had severe aSAH were included. A modified Rankin Scale score ≥ 4 or death within 3 months defined a poor outcome. hsT levels were measured at ICU admission and 72 hours following symptom onset.Results: A total of 137 patients were analyzed. The median hsT level was 29 ng/L (range: 7–4485). The best threshold level of hsT for predicting a poor outcome was 22 ng/L. At this threshold, the sensitivity was 71% (95% confidence interval [CI]: 58%-81%) and the specificity was 58% (95%CI: 46%-70%). The area under the ROC curve was 0.61 (95%CI: 0.52–0.71). Based on a multivariate analysis, the independent factors for a poor neurological prognosis were a World Federation of Neurologic Surgeons (WFNS) score ≥ 4 (odds ratio [OR]: 2.61; 95%CI: 1.04–6.56) and an hsT level > 22 ng/L (OR: 2.80; 95%CI: 1.18–6.64).Conclusion: In patients with severe aSAH, with regard for the severity of disease (assessed by the WFNS score), an hsT level > 22 ng/L at ICU admission was associated with poor outcomes.
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Guette et al. (2019) conducted an observational in severe aneurysmal subarachnoid hemorrhage (aSAH) (n=137). High-sensitivity troponin T (hsT) level > 22 ng/L vs. hsT level ≤ 22 ng/L was evaluated on Poor outcome (modified Rankin Scale score ≥ 4 or death within 3 months) (OR 2.80, 95% CI 1.18-6.64). In patients with severe aneurysmal subarachnoid hemorrhage, an hsT level > 22 ng/L at ICU admission was independently associated with poor outcomes at 3 months (OR 2.80; 95% CI 1.18-6.64).
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