The association between elevated troponin levels and all cause 30 day mortality in critically ill patients seen at an Academic Hospital – a prospective cohort study

Abstract

PURPOSES : Elevated cardiac troponins have been shown to be associated with mortality in critical care, but its utility is not well established, especially in the setting of renal failure. This study aimed to examine the relationship between an early elevated troponin level and all cause 30 day mortality in critically ill patients, and in the subgroup of patients with renal failure. METHODS : Serum troponin levels were collected from all patients referred to a critical care team, be they medical or surgical, within 48 hours of referral. The study was a prospective cohort over a six month period. Patients’ outcome was followed up to 30 days post enrolment. RESULTS : A total of 202 patients were enrolled in the study over a period of 6 months. One hundred and thirty one patients survived to 30 days (64.9%). A statistically significant association with troponin elevation and mortality was found (p = 0.008). Higher levels of troponin were also associated with higher mortality in the subjects studied. Once adjusted for renal failure, a relative risk of death of 2.27 (p = 0.012) was found with troponin values above 325 ng/L.