Abdalla Mohammed, Sohal Sumit, Al-Azzam Baha'a, Mohamed Wiam
Presence Saint Francis Hospital, Evanston, IL, USA.
University of Khartoum, Khartoum, Sudan.
J Clin Med Res. 2019 Feb;11(2):127-132. doi: 10.14740/jocmr3713. Epub 2019 Jan 5.
Sepsis is a leading cause of mortality and morbidity. Recent studies suggest that troponin elevation is associated with increased mortality in sepsis patients. The purpose of this study is to determine the effect of troponin elevation on mechanical ventilation duration and intensive care unit (ICU) length of stay in patients with sepsis. Additionally, we investigated the association between troponin elevation and septic shock.
The study is a retrospective observational cohort study, conducted in a community teaching hospital between October 2015 and April 2018. All adult ICU patients with sepsis who required invasive mechanical ventilation were included. Primary outcomes were mechanical ventilation duration and ICU length of stay. Secondary outcomes were hospital length of stay, in-hospital mortality and association with septic shock.
A total of 125 patients were included. Troponin was elevated in 36% (45/125) of the patients. Duration of mechanical ventilation in hours was longer for troponin-positive group (troponin positive: 55.6 h vs. troponin negative: 49.6 h, 95% CI 0.001 - 0.063, P = 0.032). ICU length of stay was similar (troponin positive: 4.6 days vs. troponin negative: 4.3 days, 95% CI 0.130 - 0.270). Septic shock had higher occurrence in elevated troponin group (troponin positive: 62.2% (28/45) vs. troponin negative: 43.8% (35/80), risk ratio (RR) 1.4, P = 0.04, 95% CI 1.015 - 1.99).
Troponin elevation was associated with longer duration of mechanical ventilation in patients admitted to ICU with sepsis. Troponin elevation was associated with higher risk for development of septic shock. No significant effect was observed in ICU length of stay and hospital length of stay.
脓毒症是导致死亡和发病的主要原因。近期研究表明，肌钙蛋白升高与脓毒症患者死亡率增加相关。本研究的目的是确定肌钙蛋白升高对脓毒症患者机械通气时间和重症监护病房（ICU）住院时间的影响。此外，我们还研究了肌钙蛋白升高与脓毒性休克之间的关联。
本研究为一项回顾性观察队列研究，于2015年10月至2018年4月在一家社区教学医院进行。纳入所有需要有创机械通气的成年脓毒症ICU患者。主要结局为机械通气时间和ICU住院时间。次要结局为住院时间、院内死亡率以及与脓毒性休克的关联。
共纳入125例患者。36%（45/125）的患者肌钙蛋白升高。肌钙蛋白阳性组的机械通气时长（小时）更长（肌钙蛋白阳性：55.6小时 vs. 肌钙蛋白阴性：49.6小时，95%可信区间[CI] 0.001 - 0.063，P = 0.032）。ICU住院时间相似（肌钙蛋白阳性：4.6天 vs. 肌钙蛋白阴性：4.3天，95% CI 0.130 - 0.270）。肌钙蛋白升高组脓毒性休克的发生率更高（肌钙蛋白阳性：62.2%（28/45） vs. 肌钙蛋白阴性：43.8%（35/80），风险比[RR] 1.4，P = 0.04，95% CI 1.015 - 1.99）。
脓毒症入住ICU患者中，肌钙蛋白升高与机械通气时间延长相关。肌钙蛋白升高与脓毒性休克发生风险较高相关。在ICU住院时间和住院时间方面未观察到显著影响。
