Cardiac troponin I is associated with ICU admission in pediatric patients with RSV

IF 2.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinical biochemistry Pub Date : 2025-03-01 DOI:10.1016/j.clinbiochem.2025.110896

Meghan Brown, Sydney Lawless, Brittany Roemmich, Stephen M Roper, Christopher W. Farnsworth

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引用次数: 0

Abstract

Background

Respiratory syncytial virus (RSV) is associated with morbidity and mortality in pediatric patients, but limited tools exist for prognostication of outcomes that may facilitate more rapid treatment. We assessed the utility of cardiac troponin I (cTnI) to prognosticate intensive care unit (ICU) length of stay (LOS) and bronchiolitis in pediatric patients.

Methods

Remnant EDTA plasma from 114 patients 6 months-18 years positive for RSV were enrolled. Forty-five patients with other respiratory infections were included as controls. The electronic medical record was assessed for demographic information. High sensitivity cTnI was assessed on an Abbott ARCHITECT i2000 within 24 h of collection. Proportions were compared using Fisher’s exact test and multivariable logistic regression performed.

Results

Of patients admitted to ICU with RSV, 56.9 % had cTnI ≥ the limit of detection (LOD) compared to 27.0 % of patients not admitted to the ICU. Receiver operator characteristic analysis revealed an area of 0.62 (0.53–0.72) for predicting ICU admission. At the limit of quantitation, cTnI had a sensitivity of 25.8 %, a specificity of 88.9 %, and a positive likelihood ratio of 2.32 for ICU admission. Multivariable logistic regression revealed that log2 increases in cTnI (doubling) was associated with an odds ratio (OR) of 1.34 (95 % CI: 1.03–1.78) for ICU admission. cTnI > the LOD was associated with an OR of 2.37 (1.03–5.57) for ICU admission and bronchiolitis (2.78, 1.09–7.83).

Conclusions

Elevated cTnI above the LOD was associated with ICU admission and bronchiolitis in pediatric patients presenting with RSV. Further studies are needed to verify this finding.

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心脏肌钙蛋白I与儿科呼吸道合胞病毒患者入住ICU有关。

背景：呼吸道合胞病毒（RSV）与儿科患者的发病率和死亡率相关，但现有的预测预后的工具有限，可能有助于更快速的治疗。我们评估了心肌肌钙蛋白I （cTnI）在预测重症监护病房（ICU）住院时间（LOS）和小儿细支气管炎患者中的应用。方法：收集114例RSV阳性患者6 个月-18 年的剩余EDTA血浆。45例其他呼吸道感染患者作为对照。评估了电子病历的人口统计信息。在采集后的24 h内，在雅培ARCHITECT i2000上评估高灵敏度cTnI。比例比较采用Fisher精确检验和多变量逻辑回归。结果：入住ICU的RSV患者中，56.9% %的患者cTnI ≥ 检出限（LOD），而未入住ICU的患者为27.0% %。接收操作者特征分析显示，预测ICU入住的面积为0.62（0.53-0.72）。在定量限下，cTnI的敏感性为25.8 %，特异性为88.9 %，进入ICU的阳性似然比为2.32。多变量logistic回归显示，ICU入院时cTnI的log2增加（加倍）与比值比（OR）为1.34（95 % CI: 1.03-1.78）相关。ICU住院和毛细支气管炎患者的病死率分别为2.37（1.03-5.57）和2.78（1.09-7.83）。结论：高于LOD的cTnI升高与儿科呼吸道合胞病毒患者的ICU住院和细支气管炎有关。需要进一步的研究来证实这一发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical biochemistry 医学-医学实验技术

CiteScore

5.10

自引率

0.00%

发文量

151

审稿时长

25 days

期刊介绍： Clinical Biochemistry publishes articles relating to clinical chemistry, molecular biology and genetics, therapeutic drug monitoring and toxicology, laboratory immunology and laboratory medicine in general, with the focus on analytical and clinical investigation of laboratory tests in humans used for diagnosis, prognosis, treatment and therapy, and monitoring of disease.