Abstract Ref Number = APCP1190
CORRELATION OF TROPONIN (TROPONIN T, TROPONIN I) WITH PELOD-2 SCORE IN SEPSIS AS A PREDICTIVE FACTOR OF MORTALITY
Aileen Dauhan,Aridamuriany Lubis,Munar Lubis,Erna Mutiara
Department of Child Health Faculty of Medicine Universitas Sumatera Utara Department of Child Health, Faculty of Medicine Universitas Sumatera Utara Faculty of Public Health, Universitas Sumatera Utara
Background : Sepsis in children with cardiovascular complication can increase mortality. Recently, many studies have been conducted to investigate troponin as an early marker of myocardial dysfunction, associated with pediatric sepsis score. Pediatric Logistic Organ Dysfunction 2 (PELOD-2) score is recent scoring to assess organ dysfunction in sepsis children. This study aims to determine the correlation between troponin T, troponin I with PELOD-2 score in sepsis as a predictive factor of mortality.
Material : A prospective observational analytic study was conducted on sepsis children in PICU Haji Adam Malik General Hospital, Medan. Assessment of PELOD-2 score, serum troponin T, and troponin I levels performed on the first day and 48 hours after sepsis was diagnosed. Patients were observed until moved to the ward or died.
Results : 41 subjects were recruited in this study. Troponin T level at 24 hours did not correlate with PELOD-2 scores. Troponin T level at 48 hours was positively correlated with PELOD-2 score (r=0.771, p<0.001) and had a significant association with the mortality rate (p<0.001). Troponin T at 48 hours could be used as a predictive factor of mortality (AUC 86.4%, p<0.001) with a cut-off point of 40.3 ng/mL (76% sensitivity, 75% specificity, OR 9.5). Troponin I levels at 24 and 48 hours also had correlation with PELOD-2 score (r=0.326, p=0.037; r=0.829, p<0.001) and could be used as a predictor of mortality in pediatric patients with sepsis (AUC 74.8%, p 0.008; AUC 92.6%, p<0.001). The cut-off point of troponin I at 24 hours was 0.075 ng/mL (68% sensitivity, 68.8% specificity, OR 4.67) and at 48 hours was 0.125 ng/mL (80% sensitivity, 81.2% specificity, OR 17.33).
Conclusions : Serum troponin T and troponin I levels at 48 hours have correlation with PELOD-2 score as a predictive factor of mortality in pediatric patients with sepsis.
Keywords: troponin PELOD-2 sepsis mortality