Critical illness other than sepsis

Troponin has also been recognized as an independent biomarker of mortality among critically ill patients (34-37). An initial observational study examining 209 admissions to a medical and respiratory intensive care unit (ICU) showed that 32 (15%) had increased cTnI (34). However, only 12 ofthese 32 patients (37%) were recognized as having myocardial injury by the medical staff, with 20 patients (63%) unrecognized without the assistance of cTnI. Mortality in patients with increased cTnI was 40% compared with 15% in patients with normal troponin values. These findings were confirmed in a study that observed increased short-term mortality in noncardiac patients presenting at the emergency department (ED) (37). Patients presenting with an increased cTnI had an RR of death of 3.08 within 5 d of presentation, as shown in Fig. 5 (37).

Fig. 5. Survival curves of noncardiac, critically ill ED patients stratified by cTnI concentrations. (Reproduced from ref. 37.)

Fig. 5. Survival curves of noncardiac, critically ill ED patients stratified by cTnI concentrations. (Reproduced from ref. 37.)

Fig. 6. Relationship between cTnI and severity of myocarditis in 53 patients. Solid ovals between black bars represent the mean ± SE for each group. (Reproduced from ref. 39.)

Fig. 6. Relationship between cTnI and severity of myocarditis in 53 patients. Solid ovals between black bars represent the mean ± SE for each group. (Reproduced from ref. 39.)

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