Prognostic Value of hs-cTnT for Mortality in Patients with Sepsis at Thong Nhat Hospital

Tóm tắt

   Background/Objectives: Sepsis remains a leading cause of mortality in critically ill patients, with myocardial injury playing a crucial role in disease progression. High-sensitivity cardiac troponin T (hs-cTnT) has emerged as a potential biomarker for cardiac dysfunction in sepsis, yet its prognostic significance remains under investigation. This study aimed to evaluate the prognostic value of hs-cTnT levels and their dynamic changes in predicting 28- day mortality among sepsis patients at Thong Nhat Hospital.

   Methods: A prospective observational cohort study was conducted on adult sepsis patients admitted to the Intensive Care Unit (ICU). Serial hs-cTnT measurements were obtained at admission and 24 hours post-admission. The primary outcome was 28-day all-cause mortality. Statistical analysis included receiver operating characteristic (ROC) curve evaluation, logistic regression modeling, and Youden’s index determination for optimal cutoff values.

   Results: A total of 60 sepsis patients were included. The prevalence of hs-cTnT elevation (>14 ng/L) at admission and 24 hours was 98.3%. The area under the ROC curve (AUC) for hs-cTnT at admission in predicting mortality was 0.574, which improved to 0.691 at 24 hours. The absolute changes in hs-cTnT over 24 hours had higher prognostic value, with AUC of 0.768.

   Conclusions: This study demonstrates that dynamic changes in hs-cTnT over 24 hours provide superior prognostic accuracy for 28-day mortality in sepsis patients compared to single-timepoint measurements. Serial hs-cTnT assessments may enhance risk stratification and aid in clinical decision-making for critically ill sepsis patients.

DOI: 10.59715/pntjmp.4.2.14