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European Journal of Trauma and Emergency Surgery

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Open Access 08-12-2021 | Thoracic Trauma | Original Article

Incidence and prognosis of myocardial injury in patients with severe trauma

Authors: Alexandra Stroda, Simon Thelen, René M’Pembele, Antony Adelowo, Carina Jaekel, Erik Schiffner, Dan Bieler, Michael Bernhard, Ragnar Huhn, Giovanna Lurati Buse, Sebastian Roth

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2022

Abstract

Purpose

Severe trauma can lead to end organ damages of varying severity, including myocardial injury. In the non-cardiac surgery setting, there is extensive evidence that perioperative myocardial injury is associated with increased morbidity and mortality. The impact of myocardial injury on outcome after severe trauma has not been investigated adequately yet. We hypothesized that myocardial injury is associated with increased in-hospital mortality in patients with severe trauma.

Materials/methods

This retrospective cohort study included patients ≥ 18 years with severe trauma [defined as injury severity score (ISS) ≥ 16] that were admitted to the resuscitation room of the Emergency Department of the University Hospital Duesseldorf, Germany, between 2016 and 2019. The main endpoint was in-hospital mortality. Main exposure was myocardial injury at arrival [defined as high-sensitive troponin T (hsTnT) > 14 ng/l]. For statistical analysis, receiver operating characteristic curve (ROC) and multivariate binary logistic regression were performed.

Results

Out of 368 patients, 353 were included into statistical analysis (72.5% male, age: 55 ± 21, ISS: 28 ± 12). Overall in-hospital mortality was 26.1%. Myocardial injury at presentation was detected in 149 (42.2%) patients. In-hospital mortality of patients with and without myocardial injury at presentation was 45% versus 12.3%, respectively. The area under the curve (AUC) for hsTnT and mortality was 0.76 [95% confidence interval (CI) 0.71–0.82]. The adjusted odds ratio of myocardial injury for in-hospital mortality was 2.27 ([95%CI 1.16–4.45]; p = 0.017).

Conclusion

Myocardial injury after severe trauma is common and independently associated with in-hospital mortality. Thus, hsTnT might serve as a new prognostic marker in this cohort.

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Title: Incidence and prognosis of myocardial injury in patients with severe trauma
Authors: Alexandra Stroda
Simon Thelen
René M’Pembele
Antony Adelowo
Carina Jaekel
Erik Schiffner
Dan Bieler
Michael Bernhard
Ragnar Huhn
Giovanna Lurati Buse
Sebastian Roth
Publication date: 08-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Thoracic Trauma
Polytrauma
Thoracic Trauma
Polytrauma
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01846-2

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Springer Medicine

Incidence and prognosis of myocardial injury in patients with severe trauma

Abstract

Purpose

Materials/methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials/methods

Results

Conclusion

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