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首页> 外文期刊>Critical care : >The role of cardiac troponin I as a prognosticator in critically ill medical patients: a prospective observational cohort study.
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The role of cardiac troponin I as a prognosticator in critically ill medical patients: a prospective observational cohort study.

机译：心脏肌钙蛋白I作为危重病患者预后的作用：一项前瞻性观察性队列研究。

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INTRODUCTION: Myocardial injury is frequently unrecognized in intensive care unit (ICU) patients. Cardiac troponin I (cTnI), a surrogate of myocardial injury, has been shown to correlate with outcome in selected groups of patients. We wanted to determine if cTnI level measured upon admission is an independent predictor of mortality in a heterogeneous group of critically ill medical patients. METHODS: We conducted a prospective observational cohort study; 128 consecutive patients admitted to a medical ICU at a tertiary university hospital were enrolled. cTnI levels were measured within 6 h of admission and were considered positive (>0.7 ng/ml) or negative. A variety of clinical and laboratory variables were recorded. RESULTS: Both cTnI positive and negative groups were similar in terms of age, sex and pre-admission co-morbidity. In a univariate analysis, positive cTnI was associated with increased mortality (OR 7.0, 95% CI 2.44-20.5, p < 0.001), higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores and a higher rate of multi-organ failure and sepsis. This association between cTnI and mortality was more pronounced among elderly patients (>65 years of age). Multivariate analysis controlling for APACHE II score revealed that elevated cTnI levels are not independently associated with 28-day mortality. CONCLUSION: In critically ill medical patients, elevated cTnI level measured upon admission is associated with increased mortality rate. cTnI does not independently contribute to the prediction of 28-day mortality beyond that provided by APACHE II.
机译：简介：重症监护病房（ICU）患者经常无法识别心肌损伤。心肌肌钙蛋白I（cTnI）是心肌损伤的替代物，已显示与选定患者组的预后相关。我们想确定入院时测量的cTnI水平是否是异质危重医疗患者死亡率的独立预测因子。方法：我们进行了一项前瞻性观察队列研究。招收了一家三级大学医院的医疗重症监护病房连续入院的128位患者。 cTnI水平在入院后6小时内测量，被认为是阳性（> 0.7 ng / ml）或阴性。记录了各种临床和实验室变量。结果：cTnI阳性和阴性组在年龄，性别和入院前合并症方面均相似。在单因素分析中，cTnI阳性与死亡率增加（OR 7.0，95％CI 2.44-20.5，p <0.001），急性生理和慢性健康评估（APACHE）II评分较高以及多器官衰竭和败血症。 cTnI和死亡率之间的这种关联在老年患者（> 65岁）中更为明显。控制APACHE II评分的多变量分析显示，升高的cTnI水平与28天死亡率并非独立相关。结论：在危重病患者中，入院时测得的cTnI水平升高与死亡率增加相关。 cTnI并不能独立地预测APACHE II所提供的28天死亡率。

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