Tazón-Varela Manuel Antonio, Ortiz de Salido-Menchaca Jon, Muñoz-Cacho Pedro, Iriondo-Bernabeu Enara, Martos-Almagro María Josefa, Lavín-López Emma, Vega-Zubiaur Ander, Escalona-Canal Edgar José, Alcalde-Díez Iratxe, Gómez-Vildosola Carmen, Belzunegui-Gárate Ainhoa, Espinoza-Cuba Fabiola, López-Cejuela José Antonio, García-García Alba, Torrejón-Cereceda Alejandro, Nisa-Martínez Elena Sabina, Moreira Nieto Diana, Hellín-Mercadal Cintia, García-Caballero Ander, Alonso-Valle Héctor
Servicio de Urgencias, Hospital de Laredo, 39770 Laredo, Spain.
Grupo Salud Comunitaria, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain.
J Pers Med. 2022 Mar 23;12(4):520. doi: 10.3390/jpm12040520.
The purpose of the study was to analyze the relationship between the high-sensitivity troponin T levels in patients with confirmed influenza virus infection and its severity determined by mortality during the care process. In addition, a high-sensitivity troponin T cut-off value was sought to allow us to a safe discharge from the emergency department. An analytical retrospective observational study was designed in which high-sensitivity troponin T is determined as an exposure factor, patients are followed until the resolution of the clinical picture, and the frequency of mortality is analyzed. We included patients ≥ 16 years old with confirmed influenza virus infection and determination of high-sensitivity troponin T. One hundred twenty-eight patients were included (96.9% survivors, 3.1% deceased). Mean and median blood levels of high-sensitivity troponin T of survivors were 26.2 ± 58.3 ng/L and 14.5 ng/L (IQR 16 ng/L), respectively, and were statistically different when compared with those of the deceased patients, 120.5 ± 170.1 ng/L and 40.5 ng/L (IQR 266.5 ng/L), respectively, p = 0.012. The Youden index using mortality as the reference method was 0.76, and the cut-off value associated with this index was 24 ng/L (sensitivity 100%, specificity 76%, NPV 100%, PPV 4%) with AUC of 88,8% (95% CI: 79.8−92.2%), p < 0.001. We conclude that high-sensitivity troponin T levels in confirmed virus influenza infection are a good predictor of mortality in our population, and this predictor is useful for safely discharging patients from the emergency department.
本研究的目的是分析确诊为流感病毒感染患者的高敏肌钙蛋白T水平与在治疗过程中由死亡率确定的疾病严重程度之间的关系。此外,还寻求一个高敏肌钙蛋白T的临界值,以便我们能让患者从急诊科安全出院。设计了一项分析性回顾性观察研究,将高敏肌钙蛋白T确定为暴露因素,对患者进行随访直至临床表现消退,并分析死亡率。我们纳入了年龄≥16岁、确诊为流感病毒感染且检测了高敏肌钙蛋白T的患者。共纳入128例患者(96.9%存活,3.1%死亡)。存活患者的高敏肌钙蛋白T平均血药浓度和中位数分别为26.2±58.3 ng/L和14.5 ng/L(四分位间距16 ng/L),与死亡患者相比有统计学差异,死亡患者分别为120.5±170.1 ng/L和40.5 ng/L(四分位间距266.5 ng/L),p = 0.012。以死亡率作为参考方法的约登指数为0.76,与该指数相关的临界值为24 ng/L(灵敏度100%,特异度76%,阴性预测值100%,阳性预测值4%),曲线下面积为88.8%(95%置信区间:79.8−92.2%),p < 0.001。我们得出结论,确诊为流感病毒感染患者的高敏肌钙蛋白T水平是我们研究人群死亡率的良好预测指标,该预测指标有助于患者从急诊科安全出院。