The PROTROPIC feasibility study : prognostic value of elevated troponins in critical illness
PURPOSE: Elevated cardiac troponin concentrations in people with critical illness are associated with an increased risk of death. We aimed to assess the feasibility of a larger study to ascertain the utility of cardiac troponin as a prognostic tool for mortality in critically ill patients.
METHODS: Patients admitted to participating intensive care units during the one-month enrolment period were eligible. We excluded cardiac surgical patients and patients who were admitted and either died or were discharged within 12 hr. In enrolled patients, we measured high-sensitivity cardiac troponin I (hs-cTnI) and obtained electrocardiograms to ascertain the incidence of myocardial infarction (MI) and isolated troponin elevation. Our feasibility objectives were to measure recruitment rate, the proportion of patients who consented under a deferred consent model, and time required for data collection and study procedures.
RESULTS: Over a four-week enrolment period, 280 patients were enrolled using a deferred consent model. We obtained subsequent consent from 81% of patients. Study procedures and data collection required 1.7 hr per participant. Overall, 86 (38%) suffered a MI, 23 (10%) had an isolated hs-cTnI elevation, and 117 (52%) had no hs-cTnI elevation. The crude hospital mortality rate was 10% without an hs-cTnI elevation, 29% with an isolated hs-cTnl elevation (relative risk [RR]) 2.2; 95% confidence interval [CI], 1.0 to 6.0) and 29% with an MI (RR, 2.6; 95% CI, 1.4 to 5.1).
CONCLUSION: Myocardial injury with elevated hs-cTnI concentrations and MIs occur frequently during critical illness. This pilot study has established the feasibility of conducting a large-scale investigation addressing this issue.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:66 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - 66(2019), 6 vom: 29. Juni, Seite 648-657 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
L’étude de faisabilité PROTROPIC : valeur pronostique de l’élévation des troponines dans une maladie critique |
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| Beteiligte Personen: |
Belley-Cote, Emilie P [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 01.10.2020 Date Revised 01.10.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s12630-019-01375-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM296574163 |
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| 100 | 1 | |a Belley-Cote, Emilie P |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The PROTROPIC feasibility study |b prognostic value of elevated troponins in critical illness |
| 246 | 3 | 3 | |a L’étude de faisabilité PROTROPIC : valeur pronostique de l’élévation des troponines dans une maladie critique |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: Elevated cardiac troponin concentrations in people with critical illness are associated with an increased risk of death. We aimed to assess the feasibility of a larger study to ascertain the utility of cardiac troponin as a prognostic tool for mortality in critically ill patients | ||
| 520 | |a METHODS: Patients admitted to participating intensive care units during the one-month enrolment period were eligible. We excluded cardiac surgical patients and patients who were admitted and either died or were discharged within 12 hr. In enrolled patients, we measured high-sensitivity cardiac troponin I (hs-cTnI) and obtained electrocardiograms to ascertain the incidence of myocardial infarction (MI) and isolated troponin elevation. Our feasibility objectives were to measure recruitment rate, the proportion of patients who consented under a deferred consent model, and time required for data collection and study procedures | ||
| 520 | |a RESULTS: Over a four-week enrolment period, 280 patients were enrolled using a deferred consent model. We obtained subsequent consent from 81% of patients. Study procedures and data collection required 1.7 hr per participant. Overall, 86 (38%) suffered a MI, 23 (10%) had an isolated hs-cTnI elevation, and 117 (52%) had no hs-cTnI elevation. The crude hospital mortality rate was 10% without an hs-cTnI elevation, 29% with an isolated hs-cTnl elevation (relative risk [RR]) 2.2; 95% confidence interval [CI], 1.0 to 6.0) and 29% with an MI (RR, 2.6; 95% CI, 1.4 to 5.1) | ||
| 520 | |a CONCLUSION: Myocardial injury with elevated hs-cTnI concentrations and MIs occur frequently during critical illness. This pilot study has established the feasibility of conducting a large-scale investigation addressing this issue | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 7 | |a Troponin I |2 NLM | |
| 700 | 1 | |a Whitlock, Richard P |e verfasserin |4 aut | |
| 700 | 1 | |a Ulic, Diana V |e verfasserin |4 aut | |
| 700 | 1 | |a Honarmand, Kimia |e verfasserin |4 aut | |
| 700 | 1 | |a Khalifa, Abubaker |e verfasserin |4 aut | |
| 700 | 1 | |a McClure, Graham R |e verfasserin |4 aut | |
| 700 | 1 | |a Gibson, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Alshamsi, Fayez |e verfasserin |4 aut | |
| 700 | 1 | |a D'Aragon, Frederick |e verfasserin |4 aut | |
| 700 | 1 | |a Rochwerg, Bram |e verfasserin |4 aut | |
| 700 | 1 | |a Duan, Erick |e verfasserin |4 aut | |
| 700 | 1 | |a Savija, Nevena |e verfasserin |4 aut | |
| 700 | 1 | |a Karachi, Tim |e verfasserin |4 aut | |
| 700 | 1 | |a Lamontagne, François |e verfasserin |4 aut | |
| 700 | 1 | |a Kavsak, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Cook, Deborah J |e verfasserin |4 aut | |
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