Effect of Troponin I Elevation on Duration of Mechanical Ventilation and Length of Intensive Care Unit Stay in Patients With Sepsis

Abdalla, Mohammed; Sohal, Sumit; Al-Azzam, Bahaâ€TMa; Mohamed, Wiam

doi:10.14740/jocmr3713

Cited by 10 publications

(18 citation statements)

References 25 publications

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“…We found that myocardial injury is an independent risk factor for weaning failure from mechanical ventilation [25]. Abdalla et al also demonstrated that troponin elevation was associated with a longer duration of mechanical ventilation in patients who were admitted to the ICU with sepsis [22].…”

Section: Discussionsupporting

confidence: 57%

“…Myocardial injury may be caused by hypoperfusion, hypoxia, global ischaemia, surgery, and sepsis in noncardiac patients. Previous studies showed that myocardial injury was associated with mortality among patients undergoing noncardiac surgery [16,[22][23][24]. A prospective cohort study recruited 21,842 patients who underwent noncardiac surgery at 23 centres in 13 countries.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of prolonged mechanical ventilation in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

Zhao

Wang

Lyu

et al. 2020

Preprint

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BackgroundMaternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women.MethodsThe clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV.ResultsOut of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 hours. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) = 1.296, P = 0.029), acute kidney injury (AKI) (OR = 4.305, P = 0.013), myocardial injury (OR = 4.586, P = 0.012), and PaO2/FiO2 (OR = 0.989, P < 0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934.ConclusionsEstimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Prediction of prolonged mechanical ventilation in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

Zhao

Wang

Lyu

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…We found that myocardial injury is an independent risk factor for weaning failure from mechanical ventilation [ 29 ]. Abdalla et al also demonstrated that troponin elevation was associated with a longer duration of mechanical ventilation in patients who were admitted to the ICU with sepsis [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review included nine studies involving 719 patients who suffer from pre-eclampsia and concluded that in such pre-eclampsia pregnant women cardiac troponin I might be elevated [26]. Previous studies also showed that myocardial injury was associated with mortality among patients undergoing noncardiac surgery [17,27,28]. Our previous study retrospectively enrolled 381 critically ill patients who underwent major abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

Prediction of mechanical ventilation greater than 24 hours in critically ill obstetric patients: ten years of data from a tertiary teaching hospital in mainland China

Zhao

Wang

Lyu

et al. 2021

BMC Pregnancy Childbirth

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Background Maternal admission to the intensive care unit (ICU) during pregnancy or in the postpartum period is a marker of severe acute maternal morbidity. Mechanical ventilation is an important and basic method of maintaining life support in the ICU, but prolonged mechanical ventilation (PMV) is associated with a prolonged length of hospital stay and other adverse outcomes. Therefore, we conducted this retrospective study to describe morbidity and further try to identify the risk factors for PMV in critically ill obstetric women. Methods The clinical data were obtained from a single-centre retrospective comparative study of 143 critically ill obstetric patients at a tertiary teaching hospital in mainland China between January 1, 2009, and December 31, 2019. PMV was defined as a mechanical ventilation length of more than 24 h. Clinical and obstetric parameters were collected to analyse the risk factors for PMV. Patients were separated into groups with and without PMV. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of PMV. Results Out of 29,236 hospital deliveries, 265 critically ill obstetric patients entered the ICU. One hundred forty-five (54.7%) of them were treated with mechanical ventilation. Two were excluded because of death within 24 h. Sixty-five critically ill obstetric patients (45.5%) underwent PMV. The independent risk factors for PMV included estimated blood loss (odds ratio (OR) =1.296, P=0.029), acute kidney injury (AKI) (OR=4.305, P=0.013), myocardial injury (OR=4.586, P=0.012), and PaO2/FiO2 (OR=0.989, P< 0.001). The area under the receiver operating characteristic (ROC) curve based on the predicted probability of the logistic regression was 0.934. Conclusions Estimated blood loss, AKI, myocardial injury, and PaO2/FiO2 were independent risk factors for PMV in critically ill obstetric patients.

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“…[3,15,16] We found that troponin I elevation was associated significantly with increased 30-day and one-year mortality. Moreover, Mohammed et al [17] reported that troponin I elevation was associated with prolonged mechanical ventilation. Differences among studies are attributable to the inclusion of only patients with severe sepsis and septic shock in previous studies, whereas our study population comprised all patients admitted to the non-cardiac ICU with various medical and surgical conditions.…”

Section: Discussionmentioning

confidence: 99%

Associations of antithrombotic agent use with clinical outcomes in critically ill patients with troponin I elevation in the absence of acute coronary syndrome

Tsai

Chou

et al. 2020

PLoS ONE

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Introduction To evaluate efficacy of antithrombotic agents in critically ill patients with elevated troponin I level during intensive care unit (ICU) admission. Methods and results It was a retrospective observational study which was conducted in a tertiary teaching hospital in Taipei, Taiwan. All patients hospitalized in ICU for >3 days and with available serum troponin I data from December 2015 to July 2017 were included. Patients with definite diagnosis of acute myocardial infarction (AMI) were excluded. We divided patients with troponin I elevation into three groups; no prescription, chronic prescription and new prescription of antithrombotic agents during ICU admission. We defined new prescription when patients were on antithrombotic agents, including antiplatelet agents, direct oral anticoagulants, and warfarin after troponin I was found to be elevated at ICU admission and chronic prescription, if antithrombotic agents were on medication list more than 30 days before ICU admission. Primary outcomes were 30-day and one-year all-cause mortality. Of 597 subjects who met inclusion criteria, 407 (68%) patients had elevated troponin I (>0.1 ng/mL) on ICU admission. These patients had increased 30-day [hazard ratio (HR), 1.679; 95% confidence interval (CI), 1.132-2.491; p = 0.009] and one-year (HR, 1.568; 95% CI, 1.180-2.083; p = 0.002) all-cause mortality compared with those without elevated troponin I. In patients with elevated troponin I, there was no significant difference of 30-day all-cause mortality among three groups (p = 0.051) whereas patients on chronic prescription showed significant survival benefit in one-year all-cause mortality when compared to those without or with new prescription (p = 0.008).

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Effect of Troponin I Elevation on Duration of Mechanical Ventilation and Length of Intensive Care Unit Stay in Patients With Sepsis

Cited by 10 publications

References 25 publications

Prediction of prolonged mechanical ventilation in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

Prediction of prolonged mechanical ventilation in critically ill obstetric patients: Ten years of data from a tertiary teaching hospital in mainland China

Prediction of mechanical ventilation greater than 24 hours in critically ill obstetric patients: ten years of data from a tertiary teaching hospital in mainland China

Associations of antithrombotic agent use with clinical outcomes in critically ill patients with troponin I elevation in the absence of acute coronary syndrome

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