A Meta Analysis On Predictive Value Of Troponin For The Prognosis Of Patients With Sepsis

Objective: To study the relationship between elevated troponin and the mortality of sepsis patients by the method of meta-analysis, and explore the predictive value of troponin for the prognosis of patients with sepsis.Methods: PUBMED, EMBASE, OVID, MEDLINE, Cochrane Library, CNKI, WANFANG, CBMdisc and VIP databases were searched for relevant publications in English and Chinese which were published during January 2001~December 2015. Qualified clinical researches were chosen according to the selection and puts forward standard which we do quality evaluation and data extraction by. We choose the type of effect model on the basis of the heterogeneity inspection results to combine data to confirm the relationship between elevated troponin and mortality, hospital days, test the publication bias by funnel plot by Revman 5.3.Results:13 literatures were finally included for meta-analysis which totally contain 2754 patients, we noticed that : 1, The APACHE Ⅱ of patients in elevated troponin group significantly increased(MD=3.43,95%CI:2.42-4.44,Z=6.65,P<0.01); 2, The vasopressors utilization rate of patients in elevated troponin group significantly increased(RR = 1.27, 95% CI: 1.11 1.44, Z = 3.53, P = 0.0004); 3, The CRRT utilization rate of patients in elevated troponin group significantly increased(OR = 3.38, 95% CI: 1.37 8.37), Z = 2.64, P = 2.64); 4, The hospital stays of patients in elevated troponin group significantly increased(MD = 5.75, 95% CI: 3.24 8.26, Z = 4.49, P < 0.01); 5, Elevated troponin not significantly affect the use of mechanical ventilation of patients with sepsis(RR = 1.12, 95% CI: 1.01 1.23, Z = 2.24, P = 0.03); 6, The morality of patients in elevated troponin group significantly increased(RR = 2.09, 95% CI: 1.78 2.44, Z = 8.05, P < 0.01)Conclusion: Patients with elevated troponin have a higher APACHE Ⅱand increased vasopressors and CRRT utilization rate with sepsis. Patients with elevated troponin have more hospital stays and higher mortality than patients without elevated troponin with sepsis. Troponin elevation has predictive value on the disease severity and prognosis of patients with sepsis.