Troponin T as a predictive marker of morbidity in patients with fractured neck of femur
Troponin T as a predictive marker of morbidity in patients with fractured neck of femur
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DOI：
10.1016/j.injury.2008.01.025
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发表时间：
2008-07-01
影响因子：
2.5
通讯作者：
Apthorp, Hugh
中科院分区：
文献类型：
--
作者：
Dawson-Bowling, Sebastian;Chettiar, Krissen;Apthorp, Hugh
简介：本研究的目的是前瞻性地评估围手术期测量肌钙蛋白T，心肌损伤的标志物，作为一个预测的发病率和死亡率的患者接受手术的股骨颈骨折neck of femoral.Method：所有患者年龄在65岁及以上的股骨颈骨折超过4个月的时间，最初包括在内。排除标准为肾衰竭、多发性肌炎和保守骨折治疗。在入院时、术后第1天和第2天测量肌钙蛋白T水平。根据当地方案，> 0.03 ng/mL的水平被视为升高。不良后果的措施是心肺事件（心肌梗死，充血性心力衰竭，不稳定型心绞痛，需要治疗的严重心律失常和肺栓塞），死亡和住院stays.Results的长度：129例股骨颈骨折。在应用排除标准后，纳入了108例患者。42例（39%）显示肌钙蛋白升高。其中，25例持续一个或多个结局并发症，而7例没有增加（p < 0.001）。肌钙蛋白升高组平均住院时间为25.7天，正常组为18.3天（p < 0.012）。肌钙蛋白升高组有9例死亡，5例无升高（p < 0.05）。讨论：髋部骨折手术后早期死亡的主要原因是心力衰竭和心肌梗死。肌钙蛋白T是一种敏感的心肌损伤的酶标志物。肌钙蛋白升高与髋部骨折之间的联系尚未得到证实。
Introduction: This study aims prospectively to assess perioperative measurement of Troponin T, a marker of myocardial injury, as a predictor of morbidity and mortality in patients undergoing surgery for fractured neck of femur.Method: All patients aged 65 years and over presenting with a fractured neck of femur over a 4-month period were initially included. Exclusion criteria were renal failure, polymyositis and conservative fracture management. Troponin T levels were measured on admission, day 1 and 2 post-surgery. According to local protocol, a level of > 0.03 ng/mL was considered to be raised. Adverse outcome measures were cardiorespiratory events (myocardial infarction, congestive cardiac failure, unstable angina, major arrhythmias requiring treatment and pulmonary embolism), death and length of inpatient stay.Results: One hundred and twenty-nine patients presented with femoral neck fractures. 108 patients were included after application of the exclusion criteria. 42 (39%) showed a Troponin rise. Of these, 25 sustained one or more outcome complications versus seven with no rise (p < 0.001). The mean hospital stay was 25.7 days for patients with elevated Troponin, 18.3 days in the normal group (p < 0.012). There were nine deaths in the raised Troponin group, and five with no rise (p < 0.05).Discussion: The principle causes of early death after hip fracture surgery are cardiac failure and myocardial infarction. Troponin T is a sensitive enzymatic marker of myocardial injury. The association between raised Troponin and hip fractures has not