Anatolian Journal of Emergency Medicine
Yazarlar: Gizem MANGAL, Serkan Emre EROĞLU, Gökhan AKSEL, Öner BOZAN
Konular:-
Anahtar Kelimeler:Pulmonary Embolism,Prognosis,Troponin
Özet: Introduction The aim of this study is to investigate the effect of troponin levels on the prognosis in patients diagnosed with PTE (Pulmonary Thromboembolism). Materials and Methodology Patients older than 18 years of age amongst the ones who were reported as pulmonary embolism by a radiologist after going under Thorax CT angiography and accepted as with pulmonary thromboembolism by a pulmonologist were included in the study. Patients under 18 years of age, patients without physical examination and history, patients with missing laboratory data, patients with a history of acute coronary syndrome, patients with chronic renal failure (creatine clearance <60), patients with acute cerebrovascular events, and patients with suspected pulmonary embolism were excluded from the study. Patients with PTE diagnosis were divided into two groups: Group 1: Patients who died in the 30-day period after PTE, Group 2: those who did not die during 30-day period after PTE. When comparing the groups, Student-t test was performed for data adhering to normal distribution and Mann-Whitney U test was performed for data not adhering to normal distribution. Frequency data were compared with Chi-Square test. ROC analysis was performed to determine the troponin prognosis level as a result of the statistically significant relationship between troponin and mortality and appropriate sensitivity and specificity cut-off values were determined. Results When the relationship between the troponin levels and the prognosis of patients with PTE in the emergency room was evaluated, it was found that the troponin values were statistically higher in the group with mortality (p=0,031). And because the Area Under Curve (AUC) value was calculated as 0.636, the troponin value was found to have a weak-to-medium significance for predicting 30-day mortality. Conclusion Troponin levels were significantly higher in patients who died in one-month period compared to the survivors in the same period. However, we believe that troponin values are not clinically useful as a marker of mortality due to low specificity and sensitivity ratios. Yet, because of its significant relationship with increased mortality, PTE patients with high troponin levels should be hospitalized and monitored more closely.