Key result
Elevated troponin I linked to ~9-fold higher mortality in mechanically ventilated patients.
Why the study?
The relationship between cardiac Troponin I levels and prognosis—including mortality, prolonged mechanical ventilation, and tracheostomy rate—among mechanically ventilated patients needed investigation.
Cohort (n=76)
No
Answers are grounded in this paper and cite their sources.
Should not yet guide ventilation decisions; leaves open troponin's prognostic role pending larger prospective studies.
Objective: The study aimed to investigate the relationship between cardiac Troponin I (cTnI) level and prognosis among mechanically ventilated patients in terms of mortality, prolonged mechanical ventilation, and tracheostomy rate. Methods: This is a prospective cohort study conducted at Quirino Memorial Medical Center, a tertiary government hospital, over a period of ten (10) months. Seventy-six (76) mechanically ventilated adult patients admitted at the medical intensive care unit, surgical intensive care unit, medical wards, and centers for neurologic sciences were included in the study. Quantitative cardiac Troponin I (cTnI) marker was measured and correlated to prognostic outcomes: a) prolonged ventilation (requiring more than 21 days), b) tracheostomy rate, and c) mortality rate. Data were analyzed using SPSS 16.0 and logistics regression with 95% confidence interval. Results: Results showed that among 76 patients, 15 patients have low cTnI levels, 11 patients have normal levels and 50 patients have elevated levels. Among patients with low cTnI levels (<0.020 ng/mL), 13 (86.7%) were extubated, 1 (6.7%) preceded tracheostomy and 1 (6.7%) expired. Those with normal range cTnI levels (0.020 - 0.060 ng/ mL), 10 (90.9%) were extubated, none (0%) preceded tracheostomy and 1 (9.1%) expired. Those with elevated cTnI levels (>0.060 ng/mL), 7 (14.0%) were extubated, 7 (14.0%) preceded tracheostomy and 36 (72.0%) expired. Conclusion: Analysis of the results showed a significant correlation of cTnI elevation with prognostic outcome proven by the p-value of < 0.0001. The risk of mortality among subjects with above normal cTnI levels were nine times (9x) higher compared to subjects with normal or low cTnI levels. Duration of intubation among patients with low normal and high cTnI levels did not differ significantly. Tracheostomy rate in the study was inconclusive.
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Santiaguel et al. (2022) conducted a cohort in Mechanically ventilated patients (n=76). Elevated cardiac Troponin I (>0.060 ng/mL) vs. Normal (0.020 - 0.060 ng/mL) or low (<0.020 ng/mL) cardiac Troponin I was evaluated on Mortality (9 times higher risk, p=< 0.0001). Elevated cardiac Troponin I (>0.060 ng/mL) was associated with a 9-fold higher risk of mortality compared to normal or low levels in mechanically ventilated adult patients (p<0.0001).
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