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Conway et al. Vessel Plus 2020;4:25 Vessel Plus
DOI: 10.20517/2574-1209.2020.19

Original Article Open Access

Troponin status predicts 30-day in-hospital mortality

Richard Conway , Declan Byrne , Seán Cournane , Deirdre O’Riordan , Seamus Coveney , Bernard Silke 1
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2
3
1
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1 Department of Internal Medicine, St James’s Hospital, Dublin 8, Ireland.
2 Medical Physics and Bioengineering Department, St James’s Hospital, Dublin 8, Ireland.
3 Envo-Geo Environmental Geoinformatics, Cork, Ireland.
Correspondence to: Dr. Bernard Silke, Department of Internal Medicine, St James’s Hospital, Dublin 8, Ireland.
E-mail: bernardsilke@physicians.ie
How to cite this article: Conway R, Byrne D, Cournane S, O’Riordan D, Coveney S, Silke B. Troponin status predicts 30-day in-
hospital mortality. Vessel Plus 2020;4:25. http://dx.doi.org/10.20517/2574-1209.2020.19

Received: 25 May 2020 First Decision: 9 Jul 2020 Revised: 20 Jul 2020 Accepted: 22 Jul 2020 Published: 15 Aug 2020

Academic Editor: Deborah B. Diercks Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: To evaluate the prognostic value of high-sensitivity cardiac troponin (hscTnT) levels in unselected emergency
Received: First Decision: Revised: Accepted: Published: x medical admissions.

Science Editor: Copy Editor: Production Editor: Jing Yu
Methods: We report on all hscTnT tests in emergency medical admissions, performed over an eight year
period from 2011-2018. The prognostic significance of hscTnT was related to 30-day in-hospital mortality with
multivariable logistic regression, adjusted for Acute Illness Severity Score, Comorbidity Score, Sepsis, and
Deprivation Status.

Results: There were 52,214 admissions from 28,982 patients during the study period. HscTnT level was a
univariate - odds ratios (OR) 1.67 [95% confidence intervals (CI): 1.60-1.73] and an independent risk predictor in
the multivariable logistic regression model - OR = 1.23 (95%CI: 1.16-1.29). 30-day in-hospital mortality increased
as a linear function of hscTnT; not performed = 3.6%, ≥ 25 ng/L = 5.3%, > 100 ng/L = 7.4%, > 1000 ng/L = 8.8%.
Increasing Comorbidity Score exacerbated risk; 30-day in-hospital mortality at a Score of 6, 10 and 16 points for
those with no hscTnT performed or hscTnT < 25 ng/L were 1.8%, 6.5% and 31.3% respectively; for hscTnT ≥ 25 ng/L
these increased to 2.2%, 8.8% and 41.3%.

Conclusion: HscTnT is prognostic in acutely ill medical patients; incorporation into hospital mortality predictive
algorithms appears warranted.

Keywords: Troponin levels, emergency medical admissions, hospital mortality

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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and indicate if changes were made.

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