Cardiac Specific Troponin I as Prognostic Factor among Non-COVID-19 Mechanically Ventilated Patients in a Tertiary Government Hospital: A Prospective Study

Objective: The study aimed to investigate the relationship between cardiac Troponin I (cTnI) level and prognosis among mechanically ventilated patients in terms of mortality, prolonged mechanical ventilation, and tracheostomy rate.

Methods: This is a prospective cohort study conducted at Quirino Memorial Medical Center, a tertiary government hospital, over a period of ten (10) months. Seventy-six (76) mechanically ventilated adult patients admitted at the medical intensive care unit, surgical intensive care unit, medical wards, and centers for neurologic sciences were included in the study. Quantitative cardiac Troponin I (cTnI) marker was measured and correlated to prognostic outcomes: a) prolonged ventilation (requiring more than 21 days), b) tracheostomy rate, and c) mortality rate. Data were analyzed using SPSS 16.0 and logistics regression with 95% confidence interval.

Results: Results showed that among 76 patients, 15 patients have low cTnI levels, 11 patients have normal levels and 50 patients have elevated levels. Among patients with low cTnI levels (<0.020 ng/mL), 13 (86.7%) were extubated, 1 (6.7%) preceded tracheostomy and 1 (6.7%) expired. Those with normal range cTnI levels (0.020 - 0.060 ng/ mL), 10 (90.9%) were extubated, none (0%) preceded tracheostomy and 1 (9.1%) expired. Those with elevated cTnI levels (>0.060 ng/mL), 7 (14.0%) were extubated, 7 (14.0%) preceded tracheostomy and 36 (72.0%) expired.

Conclusion: Analysis of the results showed a significant correlation of cTnI elevation with prognostic outcome proven by the p-value of < 0.0001. The risk of mortality among subjects with above normal cTnI levels were nine times (9x) higher compared to subjects with normal or low cTnI levels. Duration of intubation among patients with low normal and high cTnI levels did not differ significantly. Tracheostomy rate in the study was inconclusive.