Key result
Among elderly patients hospitalized after a fall, those with elevated troponin levels had a significantly higher 6-month mortality rate compared to those with normal levels (57.1% vs 23.5%, p=0.01).
Why the study?
Does measuring troponin after a fall in the elderly help identify acute coronary syndrome and predict mortality?
Observational (n=55)
No
Does measuring troponin after a fall in the elderly help identify acute coronary syndrome and predict mortality?
Elevated troponin levels are common after falls in the elderly, often indicate acute coronary syndrome or other cardiac injury, and are associated with doubled 6-month mortality.
Elevated troponin may flag higher mortality risk in elderly fall patients; leaves open whether routine measurement improves ACS detection or outcomes.
Background: Falling is a frequent problem, especially amongst elderly people, causing an increase in mortality. Risen troponin levels reflect myocardial damage but do not always indicate Acute Coronary Syndrome (ACS). The objective of this study was to assess the incidence of high troponin levels amongst people who have fallen. The secondary objectives were to define causes of the fall and provide suggestions as to appropriate management in patients who have fallen and have high troponin levels. Methods: This was a prospective, descriptive study, over 18 months. Measurement of troponin Ic levels, an ECG and a clinical examination were carried out daily for three consecutive days, on patients hospitalised after falling. Follow-up was made during 3 days then at 6 months after the patients were discharged. Results: Fifty five patients were included. The incidence of high troponin levels was 38%, and in patients with high levels, 24% were diagnosed with ACS. In other patients, troponin increase was related to heart failure, pericarditis, sepsis or stroke. The troponin level was significantly higher within the three days of an ACS. The 6 month mortality among patients with high levels of troponin was doubled (57.1% versus 23.5%). There was no correlation between creatinine clearance and troponin levels. Conclusions: High levels of troponin after falls help in diagnosis. The troponin level was highest in cases of ACS. Six month mortality was increased in cases with raised troponin. Troponin measurement can guide physicians in their daily practice.
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A 2015 study conducted an observational in Hospitalised after a fall (n=55). Elevated troponin levels (>0.4 µg/L) vs. Normal troponin levels (<0.4 µg/L) was evaluated on 6-month mortality (p=0.01). Among elderly patients hospitalized after a fall, those with elevated troponin levels had a significantly higher 6-month mortality rate compared to those with normal levels (57.1% vs 23.5%, p=0.01).
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