Prognostic Value of Serum Troponin I in Sepsis Patients

Abstract

Background: Sepsis is one of the leading causes of admission in ICU with high mortality and morbidity.Intensivists face challenges to manage sepsis in their practices particularly in a limited resource setting.The diagnosis of sepsis and its evaluation of severity are not easy because of its complex pathophysiologyand variable nature of presentation. So, researchers identified biomarkers including troponin I for potentialuse in sepsis. Of them troponin I is a useful biomarker with prognostic significance. Materials and methods: This prospective observational study was conducted among purposively selected110 patients diagnosed as sepsis at intensive care unit (ICU) in Dhaka Medical College & Hospital. Afterfulfilling the inclusion and exclusion criteria, ECG was done to exclude MI. Then troponin I was measuredwith a cut of value of 0.6 ng/ml. the patients were followed up for a period upto 30 days. Statisticalassociations between categorical variables were tested using chi-square test and mean difference ofcontinuous variables by independent t-test. Correlation between troponin I value length of ICU stays andventilator days were calculated. Results:Among 110 patients diagnosed as sepsis 56.4% had normal troponin I and 43.6% had elevatedtroponin I. Distribution of elevated troponin I was higher among male patients (77.1% vs 64.5%) thanfemale. Mean duration of ICU stay was prolonged in elevated troponin I group as like ventilator support.Positive relationship was found between troponin level I and duration of ventilator support as well aslength of ICU stay (r=0.225, 0.279). There was significantly increased mortality rate in elevated troponingroup of patients compared to normal troponin group (72.9% vs 35.5%) in sepsis patients (p<0.001) followedby in severe sepsis 67.5% vs 35.48% (p=0.001) and 92.9% vs 57.1%) in septic shock (p<0.029). Conclusion: This study showed that mortality and morbidity increases when troponin I value elevatedin sepsis. JBSA 2018; 31(1): 12-19