Significance of troponin elevation after severe traumatic brain injury

The Journal of Trauma
Ali SalimDemetrios Demetriades

Abstract

Elevation of serum troponin (cTnI) after nontraumatic cerebral insult has been associated with an adverse prognosis. This association has not been well documented in traumatic brain injury (TBI). To evaluate the association and prognostic significance of cTnI elevation in severe TBI. To evaluate the role of beta-blocker (BB) therapy in TBI patients with elevated cTnI. Retrospective review of all blunt trauma patients with severe TBI (head Abbreviated Injury Scale score [AIS] >/=3) admitted to the intensive care unit (ICU) with serial TnI measurements at a Level I trauma center from January 1998 to December 2005. Patients with AIS score >/=3 to other body regions were excluded. Univariate and multivariate logistic regression was performed to determine prognostic significance of TnI elevation. There were 420 severe blunt TBI patients who had serial cTnI measurements during the study period. One hundred twenty-five (29.8%) had an elevated admission cTnI. TBI patients with an elevated cTnI had a lower admission Glasgow Coma Scale (GCS) score (7.5 vs. 8.7, p < 0.05), higher Injury Severity Score (27.4 vs. 24.8, p < 0.01), and increased hospital mortality (44% vs. 29%, p < 0.05), compared with TBI patients with a normal cTnI. Increas...Continue Reading

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