Cardiac troponin-T combined with Hemoglobin and some clinical characteristics to predict mortality of sepsis patients in adult: A retrospective cohort study
Authors: Xu Kai-Zhi , Xu Ping , Li Juan-Juan , Zuo A-Fang , Wang Shu-Bao , Han Fan 
Published: March 2022

Abstract
Objective: This study was conducted to evaluate the prognostic value of serum cardiac troponinT(cTnT) combined with hemoglobin level and some clinical characteristics in patients with sepsis in ICU.Methods: Data were extracted from an online database called Multiparameter Intelligent Monitoring in Intensive Care III. 2886 patients were included. All patients were divided into survival group and death group according to whether they died during hospitalization. Demographic characteristics of patients and laboratory data of peripheral blood cTnT, hemoglobin, lactic acid, creatinine, sodium, potassium, glucose, white blood cell count, Sequential Organ Failure Assessment (SOFA) score , respiratory rate and heart rate of patients admitted to ICU were collected to analyze the differences of each variable between the two groups. Multivariate Logistic regression was used to analyze the influence of factors on hospital mortality。We use Receiver operating characteristic (ROC) curve to analyze the value of each index to evaluate the clinical prognosis of patients admitted to ICU.Results: Age, respiration rate, heart rate, SOFA score, troponin T, serum potassium, creatinine, urea and lactic acid levels in death group were significantly higher than those in survival group (all P < 0.05), while platelet, serum sodium and hemoglobin levels were significantly lower than those in survival group (all P<0.05).Multivariate Logistic regression analysis showed that mortality was significantly higher in older patients (OR: 1.022, 95%CI 1.015 to 1.029, P<0.001). At the same time, respiratory rate and heart rate at admission to ICU also significantly affected the prognosis of patients (OR: 1.019, 1.008, P =0.001, P<0.001, respectively), SOFA score was positively correlated with mortality (OR: 1.141, 95%CI 1.114 to 1.148, P< 0.001). Increased cTnT and lactic acid levels were associated with increased mortality (OR: 1.088, 1.292, P =0.02, P<0.001, respectively). However, hemoglobin as a protective factor was significantly negatively correlated with mortality (OR: 0.948, 95%CI 0.907 to 0.991, P =0.018), and serum potassium, creatinine and urea were positively correlated with mortality (ALL P<0.05), increased serum sodium level was associated with reduced mortality as a protective factor (OR: 0.979, 95%CI 0.965 to 0.994, P =0.005).ROC curve showed that for cTnT and hemoglobin alone, The area under the receiver operating characteristic curve(AUROC) were 0.548 (95% CI.: 0.53-0.567) and 0.528 (95% CI.: 0.509-0.546); After combining other variables, AUROC reached 0.732 (95% CI.:0.715-0.748). The sensitivity and specificity were 64.2% and 70.62%, respectively, which were higher than those of single index.Conclusions: The levels of hemoglobin and cTnT in ICU patients with sepsis may affect the prognosis of patients, and the effect of multifactor combined test on the prognosis of sepsis is better than that of a single indicator. Treatment strategies that improve the factors identified in this study may improve the inpatient survival rate of these ICU patients.