Prognostic Value of Initial Troponin Ⅰ Level in Non-cardiac Surgery Critically Ill Patients at Intensive Care Unit
10.3969/j.issn.1000-3614.2018.03.011
- VernacularTitle:入重症监护室早期肌钙蛋白Ⅰ水平对非心脏手术重症患者预后的预测价值
- Author:
Hui-Ying ZHAO
1
;
Lian-Ze ZHAO
;
You-Zhong AN
Author Information
1. 北京大学人民医院 重症医学科
- Keywords:
Troponin I;
Intensive care;
Prognosis
- From:
Chinese Circulation Journal
2018;33(3):256-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the prognostic value of initial troponin Ⅰ (TnI) level in non-cardiac surgery critically ill patients at surgical intensive care unit (ICU). Methods: We consecutively observed non-cardiac surgery critically ill patients admitted in surgical ICU of our hospital from 2015-01-01 to 2015-12-31. TnI level was measured at the early ICU admission, general clinical data, previous history, acute physiology and chronic health evaluation (APACHE) Ⅱ score and mortality were compared between the patients with elevated TnI and normal TnI; TnI level at the early ICU admission, general clinical data, previous history and APACHE Ⅱ score were compared between survival patients and deceased patients. Risk factors for ICU mortality were studied by multivariable regression analysis;predictive values for initial TnI level and APACHE Ⅱ score in mortality were assessed by receiver operating curve (ROC). Results: A total of 1 193 patients were enrolled and 159 (13.3%) of them had TnI elevation upon ICU admission. Compared with normal TnI patients, TnI elevated patients had the higher APACHE Ⅱ score [17.0 (14.0-21.0) vs 15.0 (13.0-18.0)] and ICU mortality (18.2% vs 2.6%), both P=0.000. There were 56 patients died and 1 137 survived, single and multivariable regression analysis indicated that age (OR=1.041), APACHE Ⅱ score (OR=1.218) and initial TnI level (OR=6.366) were the independent risk factors for ICU mortality, all P<0.05. AUC of ROC for predictive value of ICU mortality in APACHE Ⅱ score was 0.763, in initial TnI level was 0.778; their combination AUC was 0.803. Conclusion: Increased TnI level at the early ICU admission was an independent risk factor for ICU mortality in non-cardiac surgery critically ill patients which had predictive value for death.
