Observational studyCritical care (London, England)2017
Early troponin I in critical illness and its association with hospital mortality: a cohort study.
Observational study in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- Prognostic value of combining cardiac myosin-binding protein C and N-terminal pro-B-type natriuretic peptide in patients without acute coronary syndrome treated at medical cardiac intensive care units.Heart and vessels · 2025Article
- Septic Cardiomyopathy: Difficult Definition, Challenging Diagnosis, Unclear Treatment.Journal of clinical medicine · 2025Review
- Elevated Cardiac Troponin Levels as a Predictor of Increased Mortality Risk in Non-Cardiac Critically Ill Patients Admitted to a Medical Intensive Care Unit.Journal of clinical medicine · 2024Article
- Elevated Cardiac Troponin I Level Associated to Cardiac Dysfunction in Burned Patients.Journal of burn care & research : official publication of the American Burn Association · 2024Article
- Is high sensitivity troponin, taken regardless of a clinical indication, associated with 1 year mortality in critical care patients?Journal of the Intensive Care Society · 2023Article
- Diagnoses and Outcomes of Patients with Suspicion of Acute Coronary Syndrome and Raised High Sensitive Troponin I: A Single Center Study from Pakistan.Journal of laboratory physicians · 2023Article
- Comparison of elevated cardiac troponin I with SAPS-II and APACHE-II score in predicting outcome of severe intoxications.Indian journal of anaesthesia · 2022Article
- Mechanisms of Post-critical Illness Cardiovascular Disease.Frontiers in cardiovascular medicine · 2022Review
- Septic cardiomyopathy: Diagnosis and management.Journal of intensive medicine · 2022Review
- Identifying Survivors of Sepsis at Risk for Adverse Cardiovascular Outcomes.American journal of respiratory and critical care medicine · 2021Article
- Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study.Lancet (London, England) · 2021Article
- The value of admission Troponin I to predict outcomes in suspected infections in elderly patients admitted in Internal Medicine: results from the SOFA-T collaboration, a multi-center study.Internal and emergency medicine · 2021Article
- Association of Cardiac Troponin T Concentration on Admission with Prognosis in Critically Ill Patients without Myocardial Infarction: A Cohort Study.International journal of general medicine · 2021Article
- COVID-19-Related Cardiovascular Disease and Practical Considerations for Perioperative Clinicians.Seminars in cardiothoracic and vascular anesthesia · 2020Review
- High sensitivity troponin measurement in critical care: Flattering to deceive or 'never means nothing'?Journal of the Intensive Care Society · 2020Review
- The Prognostic Role of Procalcitonin in Critically Ill Patients Admitted in a Medical Stepdown Unit: A Retrospective Cohort Study.Scientific reports · 2020Observational
- Cardiac troponin T is associated with mortality in patients admitted to critical care in a UK major trauma centre: a retrospective database analysis.Journal of the Intensive Care Society · 2019Article
- Cardiovascular Factors Associated with Septic Shock Mortality Risks.Spartan medical research journal · 2018Article
- Improving risk stratification for hospital mortality using troponin: is it time for a change of heart?Journal of laboratory and precision medicine · 2018Article
- The Relation between Sarcopenia and Mortality in Patients at Intensive Care Unit.BioMed research international · 2018Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTroponin I (TnI) is frequently elevated in critical illness, but its interpretation is unclear. Our primary objectives in this study were to evaluate whether TnI is associated with hospital mortality and if this association persists after adjusting for potential confounders. We also aimed to ascertain whether addition of TnI to the Acute Physiological and Chronic Health Evaluation II (APACHE II) risk prediction model improves its performance in general intensive care unit (ICU) populations.
methodsWe performed an observational cohort study with independent derivation and validation cohorts in two general level 3 ICU departments in the United Kingdom. The derivation cohort was a 4.5-year cohort (2010-2014) of general ICU index admissions (n = 1349). The validation cohort was used for secondary analysis of a prospective study dataset (2010) (n = 145). The primary exposure was plasma TnI concentration taken within 24 h of ICU admission. The primary outcome was hospital mortality. We performed multivariate regression, adjusting for components of the APACHE II model. We derived the risk prediction score from the multivariable model with TnI.
resultsHospital mortality was 37.3% (n = 242) for patients with detectable TnI, compared with 14.6% (n = 102) for patients without detectable TnI. There was a significant univariate association between TnI and hospital mortality (OR per doubling TnI 1.16, 95% CI 1.13-1.20, p < 0.001). This persisted after adjustment for APACHE II model components (TnI OR 1.05, 95% CI 1.01-1.09, p = 0.003). TnI correlated most strongly with the acute physiology score (APS) component of APACHE II (r = 0.39). Addition of TnI to the APACHE II model did not improve discrimination (APACHE II concordance statistic [c-index] 0.835, 95% CI 0.811-0.858; APACHE II + TnI c-index 0.837, 95% CI 0.813-0.860; p = 0.330) or other measures of model performance.
conclusionsTnI is an independent predictor of hospital mortality and correlates most highly with the APS component of APACHE II. It does not improve risk prediction. We would not advocate the adoption of routine troponin analysis on admission to ICU, and we recommend that troponin be measured only if clinically indicated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.