Key result
Elevated troponin I levels on admission in trauma patients were associated with significantly higher in-hospital mortality compared to normal levels (14.49% vs 0%).
Why the study?
Elevated troponin I is common in trauma patients and indicates myocardial injury, but blunt cardiac injury cannot be diagnosed solely by increased troponin I.
Does elevated serum troponin I predict in-hospital mortality and worse prognosis in trauma patients?
Cohort (n=166)
No
Does elevated serum troponin I predict in-hospital mortality and worse prognosis in trauma patients?
In trauma patients, failure of serum troponin I to normalize by day 7 is an independent predictor of in-hospital mortality, highlighting the prognostic value of serial biomarker monitoring.
Elevated admission troponin I was associated with higher trauma mortality; hypothesis-generating for serial monitoring before changing practice.
BACKGROUND: Elevated troponin I (TnI) is common among trauma patients. TnI is an indicator of myocardial injury, but clinical diagnosis of blunt cardiac injury cannot be based solely on an increase in TnI. Therefore, this study aims to explore the changes and clinical significance of serum TnI in trauma patients. METHODS: The clinical data of consecutive trauma patients admitted to our trauma center between July 1, 2017 and July 31, 2020 were retrospectively analyzed. According to TnI levels within 24 hours of admission, patients were divided into the elevated and normal TnI groups. According to the TnI levels after 7 days of admission, a graph depicting a change in trend was drawn and then analyzed whether TnI was related to in-hospital mortality. The TnI level of trauma patients gradually increased after admission and peaked at 48 hours (7.804±1.537 ng/mL). Subsequently, it decreased, and then recovered to normal within 7 days. However, 13 patients did not recover. Logistic regression analysis revealed that abnormal TnI at 7 days was independently related to in-hospital mortality. CONCLUSIONS: Trauma patients with elevated TnI levels may have a worse prognosis. Monitoring the changes in serum TnI is important, which can reflect the prognosis better than the TnI measured immediately after admission.
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Dou et al. (2021) conducted a cohort in Trauma (n=166). Elevated Troponin I vs. Normal Troponin I was evaluated on In-hospital mortality (p=<0.001). Elevated troponin I levels on admission in trauma patients were associated with significantly higher in-hospital mortality compared to normal levels (14.49% vs 0%).
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