Value of initial increase of troponin I level for prediction of prolonged ICU stay in critically Ill obstetric patients

doi:10.3877/cma.j.issn.2096-1537.2020.02.016

Abstract

Abstract:

Objective

To evaluate the value of initial increase of troponin I (TnI) level for prediction of prolonged intensive care unit (ICU) stay in critically ill obstetric patients.

Methods

A retrospective analysis was conducted in critically ill obstetric patients who were admitted to the ICU between January 2014 and July 2019. We divided the patients into two groups based on whether the time of stay in ICU was longer than 72 hours. Independent risk factors for stay in ICU were identified by multivariate analysis. Predictive value of initial TnI level and acute kidney injury (AKI) for ICU stay was assessed by receiver operating curve (ROC) analysis.

Results

There were 119 critically ill obstetric patients included in the study. ICU stay was prolonged in 47 cases (≥72 hours). Multivariate analysis identified that the initial increase of cardiac TnI (odds ratio=6.697, 95%CI: 1.27~35.332, P=0.025) and AKI (odds ratio=6.054, 95%CI: 1.248~29.368, P=0.025) were independent predictors for prolonged ICU stay. The areas under the reciever operating characteristic of initial increase of TnI level alone, AKI alone, and their combination for prediction of ICU stay were 0.741 (95%CI 0.65-0.832, P<0.001), 0.729 (95%CI 0.634-0.825, P<0.001), and 0.806 (95%CI 0.723-0.889, P<0.001), respectively.

Conclusion

Increased TnI level and occurence of AKI at the early ICU admission are independent risk factors for ICU stay in critically ill obstetric patients.

Key words: Troponin I, Intensive care unit, Pregnant women

Guangjie Wang, Huiying Zhao, Jie Lyu, Youzhong An. Value of initial increase of troponin I level for prediction of prolonged ICU stay in critically Ill obstetric patients[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(02): 183-186.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2020.02.016

https://icu.cma-cmc.com.cn/EN/Y2020/V06/I02/183

Figures/Tables 3

References 12

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因素	ICU住院时间非延长	ICU住院时间延长	统计值	P值
年龄（岁，±s）	32.43±5.57	31.13±5.37	t=117	0.208
孕周（周，±s）	34.1±5.37	32.73±5.9	t=-1.27	0.206
入院体质量指数（kg/m²，±s）	28.24±6.3	27.64±3.23	t=-0.66	0.517
APACHE II评分（分，±s）	14.6±4.8	17.33±4.56	t=2.26	0.027
体温（℃，±s）	37.88±0.76	38.96±1.13	t=5.68	<0.001
机械通气［例（%）］	40（55.6）	36（76.6）	χ²=5.46	0.020
二次手术［例（%）］	10（13.9）	11（23.4）	χ²=1.77	0.183
术中出血［ml，M（Q_U，Q_L）］	1000（475，3050）	2200（475，5025）	χ²=609.50	0.162
血管活性药物［例（%）］	3（4.2）	20（42.6）	χ²=26.87	<0.001
AKI［例（%）］	16（22.2）	32（68.1）	χ²=24.85	<0.001
BNP升高（>400 pg/ml）［例（%）］	19（26.4）	29（61.7）	χ²=14.74	<0.001
TnI升高（>0.04 ng/ml）［例（%）］	25（34.7）	39（83）	χ²=26.64	<0.001
总胆红素水平［μmol/L，M（Q_U，Q_L）］	11.9（8，24.4）	16.3（10.9，28.2）	χ²=1281.50	0.033
白蛋白水平（g/L，±s）	26.86±3.63	24.74±4.86	t=-2.57	0.012
血红蛋白水平（g/L，±s）	88.08±22.77	76.54±22.32	t=-2.72	0.007
乳酸水平［mmol/L，M（Q_U，Q_L）］	1.2（0.8，1.98）	1.55（0.9，3.8）	χ²=1212.00	0.042
氧合指数［mmHg，M（Q_U，Q_L）］	377（297，475）	271（207，322）	Z=820.00	<0.001

因素	ICU住院时间非延长	ICU住院时间延长	统计值	P值
年龄（岁，±s）	32.43±5.57	31.13±5.37	t=117	0.208
孕周（周，±s）	34.1±5.37	32.73±5.9	t=-1.27	0.206
入院体质量指数（kg/m²，±s）	28.24±6.3	27.64±3.23	t=-0.66	0.517
APACHE II评分（分，±s）	14.6±4.8	17.33±4.56	t=2.26	0.027
体温（℃，±s）	37.88±0.76	38.96±1.13	t=5.68	<0.001
机械通气［例（%）］	40（55.6）	36（76.6）	χ²=5.46	0.020
二次手术［例（%）］	10（13.9）	11（23.4）	χ²=1.77	0.183
术中出血［ml，M（Q_U，Q_L）］	1000（475，3050）	2200（475，5025）	χ²=609.50	0.162
血管活性药物［例（%）］	3（4.2）	20（42.6）	χ²=26.87	<0.001
AKI［例（%）］	16（22.2）	32（68.1）	χ²=24.85	<0.001
BNP升高（>400 pg/ml）［例（%）］	19（26.4）	29（61.7）	χ²=14.74	<0.001
TnI升高（>0.04 ng/ml）［例（%）］	25（34.7）	39（83）	χ²=26.64	<0.001
总胆红素水平［μmol/L，M（Q_U，Q_L）］	11.9（8，24.4）	16.3（10.9，28.2）	χ²=1281.50	0.033
白蛋白水平（g/L，±s）	26.86±3.63	24.74±4.86	t=-2.57	0.012
血红蛋白水平（g/L，±s）	88.08±22.77	76.54±22.32	t=-2.72	0.007
乳酸水平［mmol/L，M（Q_U，Q_L）］	1.2（0.8，1.98）	1.55（0.9，3.8）	χ²=1212.00	0.042
氧合指数［mmHg，M（Q_U，Q_L）］	377（297，475）	271（207，322）	Z=820.00	<0.001

因素	B	S.E.	Wals	P值	OR（95%CI）
TnI升高	1.902	0.849	5.023	0.025	6.697（1.27，35.332）
AKI	1.801	0.806	4.994	0.025	6.054（1.248，29.368）

因素	B	S.E.	Wals	P值	OR（95%CI）
TnI升高	1.902	0.849	5.023	0.025	6.697（1.27，35.332）
AKI	1.801	0.806	4.994	0.025	6.054（1.248，29.368）

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