Diagnostic significance of cardiac troponin Ⅰ in multiple trauma patients combined with myocardial contusion
PENG Na, GENG Yan, TANG Li-qun, LIU Yun-song, SU Lei
Published 2013-10-15
Cite as Chin J Trauma, 2013,29(10): 981-985. DOI: 10.3760/cma.j.issn.1001-8050.2013.10.022
Abstract
Objective To investigate the value of cardiac troponin Ⅰ (cTn Ⅰ) in diagnosis of multi-trauma patients combined with myocardiac contusion.Methods A retrospective review was made on 98 cases of multi-trauma patients combined with blunt chest trauma.The groups were identified according to whether the patients were associated with myocardiac contusion or not,including myocardiac contusion group (n =48) and non-myocardiac contusion group (n =50).The detection and diagnosis of myocardiac contusion in the use of different cut-off points of cTn Ⅰ and creatine kinase MB isoenzyme/creatine kinase (CKMB/CK) or their combination were compared between groups.Results cTn Ⅰ ≥0.60 ng/ml had a specificity of 90.0%,a sensitivity of 64.6% and a Youden index of 0.54 in diagnosis of myocardiac contusion,indicating a best diagnostic accuracy as a single parameter.As compared with the single use of cTn Ⅰ ≥ 0.60 ng/ml or CKMB/CK ≥ 6% in diagnosis of myocardiac contusion,the combined use of two parameters presented a significantly higher diagnostic sensitivity (85.4% vs 64.6% ; 85.4% vs 27.1% respectively,both P < 0.05),but no markedly lower specificity (84.0% vs 90.0% ; 84.0% vs 88.0% respectively,both P >0.05).cTn Ⅰ level was positively correlated with ISS score of the multi-trauma patients combined with myocardiac contusion (r =0.534,P < 0.01).Mortality rate in patients with severely increased cTn Ⅰ was much higher than that in patients with mild-moderately increased cTn Ⅰ (P < 0.01).Conclusions cTn Ⅰ ≥0.60 ng/ml presents a high sensitivity and preferable specificity for diagnosis of multiple trauma patients combined with myocardiac contusion.It can be served as a biomarker for diagnosis of MC and its combination with CKMB/CK≥6% improves the diagnostic sensitivity.cTn Ⅰ can be used as an assessment indicator for the early risk stratification and outcome in multi-trauma patients combined with myocardiac contusion.
Key words:
Multiple trauma; Troponin Ⅰ; Myocardial contusion
Contributor Information
PENG Na
Intensive Care Unit, Key Laboratory of Trauma Rescue and Tissue Repair of PLA in Hot Area, General Hospital of Guangzhou Military Command, Guangzhou 510010, China
GENG Yan
Intensive Care Unit, Key Laboratory of Trauma Rescue and Tissue Repair of PLA in Hot Area, General Hospital of Guangzhou Military Command, Guangzhou 510010, China
TANG Li-qun
Intensive Care Unit, Key Laboratory of Trauma Rescue and Tissue Repair of PLA in Hot Area, General Hospital of Guangzhou Military Command, Guangzhou 510010, China
LIU Yun-song
Intensive Care Unit, Key Laboratory of Trauma Rescue and Tissue Repair of PLA in Hot Area, General Hospital of Guangzhou Military Command, Guangzhou 510010, China
SU Lei
Intensive Care Unit, Key Laboratory of Trauma Rescue and Tissue Repair of PLA in Hot Area, General Hospital of Guangzhou Military Command, Guangzhou 510010, China