tailieunhanh - Báo cáo y học: " Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave. | Hausfater et al. Critical Care 2010 14 R99 http content 14 3 R99 c CRITICAL CARE RESEARCH Open Access Elevation of cardiac troponin I during non-exertional heat-related illnesses in the context of a heatwave Pierre Hausfater 1 Benoit Doumenc2 Sébastien Chopin1 Yannick Le Manach3 Aline Santin4 Sandrine Dautheville5 Anabela Patzak6 Philippe Hericord7A Bruno Mégarbane8 Marc Andronikof9 Nabila Terbaoui10 and Bruno Riou1 3 Abstract Introduction The prognostic value of cardiac troponin I cTnl in patients having a heat-related illness during a heat wave has been poorly documented. Methods In a post hoc analysis we evaluated 514 patients admitted to emergency departments during the August 2003 heat wave in Paris having a core temperature C and who had analysis of cTnl levels. cTnl was considered as normal moderately elevated abnormality threshold to or severely elevated . Patients were classified according to our previously described risk score high intermediate and low-risk of death . Results Mean age was 84 12 years mean body temperature C. cTnl was moderately elevated in 165 32 and severely elevated in 97 19 patients. One-year survival was significantly decreased in patients with moderate or severe increase in cTnl 24 and 46 vs 58 all P . Using logistic regression four independent variables were associated with an elevated cTnl previous coronary artery disease Glasgow coma scale 12 serum creatinine 120 and heart rate 110 bpm. Using Cox regression only severely elevated cTnl was an independent prognostic factor hazard ratio 95 confidence interval to when risk score was taken into account. One-year survival was decreased in patients with elevated cTnl only in high risk patients 17 vs 31 P . Conclusions cTnl is frequently elevated in patients with non-exertional heat-related illnesses during a heat wave and is an independent risk factor only in high risk patients where severe increase .