Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Visit old site
Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 776
ORIGINAL ARTICLE
Year : 2016  |  Volume : 8  |  Issue : 1  |  Page : 17-24

Troponin T in patients with traumatic chest injuries with and without cardiac involvement: Insights from an observational study


1 Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar
2 Department of Surgery, Section of Trauma Surgery, Hamad General Hospital; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar; Department of Internal Medicine, Cardiology Unit, Ahmed Maher Teaching Hospital, Cairo, Egypt
3 Department of Clinical Medicine, Weill Cornell Medical College; Department of Cardiology, Hamad General Hospital, Doha, Qatar
4 Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar; Department of Surgery, University of Arizona, Tucson, Arizona, USA

Correspondence Address:
Ayman El-Menyar
Department of Clinical Medicine, Weill Cornell Medical College, Qatar and Trauma Surgery Section, Clinical Research, Hamad General Hospital, PO Box 3050, Doha, Qatar

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1947-2714.175188

Rights and Permissions

Background: Serum troponin T (TnT) is a common marker of myocardial injury. However, its implication in the absence of clinical evidence of cardiac reason is not well established. Aims: The aim of this study was to identify the implications of positive TnT in traumatic chest injury (TCI) patients regardless of the cardiac involvement. Materials and Methods: We conducted a retrospective analysis of all TCI patients admitted to level 1 trauma center between 2008 and 2011. Patients who underwent TnT testing were divided into two groups: Group 1 (positive TnT) and Group 2 (negative TnT). The two groups were analyzed and compared, and multivariate regression analyses were performed to identify predictors of TnT positivity and mortality. Results: Out of 993 blunt TCI patients, 19.3% had positive TnT (Group 1). On comparison to Group 2, patients in Group 1 were 5 years younger and more likely to have head, cardiac, hepatic, splenic, and pelvic injuries, in addition to lung contusion. Positive TnT was associated with higher Injury Severity Score (ISS) (P = 0.001), higher chest Abbreviated Injury Score (AIS) (P = 0.001), and longer hospital stay (P = 0.03). In addition, Group 1 patients were more likely to undergo chest tube insertion, exploratory laparotomy, mechanical ventilation, and tracheostomy. Twenty patients had cardiac involvement, and of them 14 had positive TnT. Among 973 patients who showed no evidence of cardiac involvement, 178 had positive TnT (18.3%). There were 104 deaths (60% in Group 1). On multivariate regression analysis, the predictors of hospital mortality were positive TnT, head injury, and high ISS, whereas, the predictors of TnT positivity were cardiac, hepatic, and pelvic injuries; higher ISS; and age. Conclusions: Positive TnT in blunt TCI patients is a common challenge, particularly in polytrauma cases. Patients with positive TnT tend to have the worst outcome even in the absence of clinical evidence of acute cardiac involvement. Positive TnT is also a reflection of the severity of chest or extrathoracic injuries; however, further prospective studies are warranted.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1637    
    Printed33    
    Emailed0    
    PDF Downloaded256    
    Comments [Add]    
    Cited by others 11    

Recommend this journal