Prognostic Value of Cardiac Troponin I and T on Admission in Mortality of Multiple Trauma Patients Admitted to the Emergency Department: a Prospective Follow-up Study.

Abstract

Introduction:The relationship between increased levels of cardiac troponins and morbidity and mortality of traumatic patients is not still well recognized.Aim:The aim of this study was to investigate the prognostic value of cardiac troponin I and T on admission in mortality of multiple trauma patients admitted to the emergency department.Methods:In this prospective follow-up study, the cardiac troponin I and T levels were measured in patients with multiple trauma referring to the emergency department (ED) between March 2014 and February 2015 at Imam Khomeini Hospital, Sari, Iran. Patients were followed prospectively until discharge from hospital or death.Results:The levels of cardiac troponins I and T in patients with multiple trauma were significantly associated with their mortality, especially at the level of 0.5 and 1.2 μg/dl (p<0.05). Multivariate regression analysis showed association of level of cardiac troponin I and T with patients’ mortality, after controlling for patients’ age, vital signs and GCS on admission. The sensitivity and specificity of troponin I at levels greater than 0.4 μg/dl in predict mortality in this study were as 65.5% and 55.3%, while the values for troponin T were 65.1% and 54.9%, respectively.Conclusion:Elevated cardiac troponin I and T levels provide excellent prognostic information regarding mortality in patients with multiple-trauma, independent of age, hemodynamic variables and GCS score.