Correlation of Admission Troponin Levels with Cardiac Markers in Burn Patients

Abstract

Background: Patients who experience severe burn injury undergo systemic changes with specific regards to the cardiovascular system ultimately resulting in systemic hypermetabolism, increased cardiac stress and dysfunction. Troponin I has been used as a biomarker for ischemic disease and cardiac dysfunction for years. The current relationship between TnI levels and clinical cardiac markers such as HR and BP have not been well studied in burn patients. Objective: To assess if admission troponin levels correlate with BP and HR findings in patients with burn injury. Methods: A prospective observational trial of 40 burn patients with burn injury (TBSA 10% or greater) admitted to the burn unit at Valleywise Health Medical Center in Phoenix. Criteria for elevated TnI levels were based upon reference ranges provided by the hospital lab, where TnI levels less than 0.034ng/mL were considered normal, and levels >0.034ng/mL were considered elevated. Initial TnI levels, BP, HR, TBSA were collected alongside demographic information. The groups were analyzed using Wilcoxon Rank Sum for the primary continuous parameters. Result: No significant difference in Age, Gender, Ethnicity, initial SBP, DBP, MAP, HR, and total # deceased between the group of burn patients with significantly elevated TnI versus the group of burn patients with normal TnI. There was a statistically significant difference in the TBSA burned with the significantly elevated TnI having significantly more surface area burned compared to the normal TnI group, where p=0.0264. Conclusion: The level of TnI increase in burn injury does not appear to correlate with clinical markers of cardiac function such as HR and BP. Additionally, TBSA appears to be positively correlated with the level of TnI rise.