心肌肌钙蛋白T与英国一家大型创伤中心重症监护病房收治患者的死亡率相关：一项回顾性数据库分析
Cardiac troponin T is associated with mortality in patients admitted to critical care in a UK major trauma centre: a retrospective database analysis.
作者信息
Crewdson Kate, Thompson Julian, Thomas Matt
机构信息
Intensive Care Unit, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
Severn Major Trauma Network, North Bristol NHS Trust, Bristol, UK.
出版信息
J Intensive Care Soc. 2019 May;20(2):132-137. doi: 10.1177/1751143718767782. Epub 2018 Apr 4.
BACKGROUND
Elevated levels of cardiac troponin T are associated with poor outcome in critically ill patients and have been proposed as a prognostic marker in major trauma. This study investigated the relationship between cardiac troponin T levels on admission to intensive care unit (ICU) and all-cause mortality in major trauma patients.
METHODS
A retrospective database analysis of cardiac troponin T levels on admission to the ICU in major trauma patients between 1 August 2015 and 31 December 2016 at a UK Major Trauma Centre was performed.
RESULTS
Of the 243 patients, 69 (28.4%) died. Cardiac troponin T levels were significantly higher in patients who died compared to survivors: 42 vs. 13 ng/L, respectively ( < 0.0001); the odds of all-cause mortality increased significantly as troponin increased, independent of age or Acute Physiology and Chronic Health Evaluation score.
DISCUSSION
This confirms cardiac troponin T at ICU admission as a marker of mortality in major trauma. Elevated cardiac troponin T may be seen in patients without evidence of direct cardiac trauma.
背景
心肌肌钙蛋白T水平升高与危重症患者的不良预后相关，并且已被提议作为重大创伤的预后标志物。本研究调查了重症监护病房（ICU）收治时的心肌肌钙蛋白T水平与重大创伤患者全因死亡率之间的关系。
方法
对2015年8月1日至2016年12月31日期间在英国一家重大创伤中心收治入ICU的重大创伤患者的心肌肌钙蛋白T水平进行了回顾性数据库分析。
结果
243例患者中，69例（28.4%）死亡。与幸存者相比，死亡患者的心肌肌钙蛋白T水平显著更高：分别为42 ng/L和13 ng/L（<0.0001）；随着肌钙蛋白升高，全因死亡率的几率显著增加，与年龄或急性生理与慢性健康状况评分无关。
讨论
这证实了ICU收治时的心肌肌钙蛋白T可作为重大创伤死亡率的标志物。在没有直接心脏创伤证据的患者中也可能出现心肌肌钙蛋白T升高。
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