Is elevated troponin associated with in-hospital mortality in emergency department patients admitted with chronic obstructive pulmonary disease
European Journal of Emergency Medicine, 04/12/2012
Kelly AM et al. – Troponin elevation is associated with increased in–hospital mortality in emergency department (ED) patients with acute exacerbation of chronic obstructive pulmonary disease (COPD)Methods
- A retrospective cohort study of ED patients with acute exacerbations of COPD who were admitted to hospital and in whom troponin was assayed at ED presentation.
- Other data collected included demographics, clinical characteristics, test results, and outcome.
- Outcome of interest was in–hospital mortality.
- A total of 252 patients were studied, median age 73years, 61% men.
- In–hospital mortality was 4.4% [n=11; 95% confidence interval (CI) 2.5–7.7%].
- Seventy–eight patients had elevated troponin of greater than 99th centile (31%, 95% CI 26–37%).
- Factors independently associated with mortality were troponin elevation [odds ratio (OR) 8.3, 95% CI 1.58–43.7], pH less than 7.2 (OR 12.7, 95% CI 1.86–86.4), and requirement for noninvasive ventilation (OR 8.09, 95% CI 1.61–40.8).