Cardiac troponin as a prognosticator of mortality in patients with sepsis: A systematic review and meta‐analysis

BACKGROUND: The impact of cardiac troponin on the short‐term and long‐term prognosis of patients with sepsis remains uncertain. Therefore, we conducted a meta‐analysis to investigate the role of cardiac troponin as a potential indicator for sepsis mortality. METHODS: We performed a comprehensive search for articles published before November 2022 using Google Scholar, PubMed, and Web of Science. Inclusion criteria for the studies were: (1) investigation of cardiac troponin, and (2) investigation of sepsis. Exclusion criteria included: (1) inability to obtain or calculate hazard ratio (HR) and 95% confidence interval (CI) for the relationship between cardiac troponin level and sepsis mortality, and (2) reviews, meta‐analyses, and case reports. Analysis of HRs and 95% CIs for the association between cardiac troponin level and sepsis mortality was conducted using STATA 12.0 software. RESULTS: Our study included 24 prospective studies (comprising 20,457 sepsis patients) and 4 retrospective studies (comprising 1416 sepsis patients). Meta‐analysis demonstrated that elevated cardiac troponin levels were significantly associated with increased sepsis mortality using a random effects model (HR = 1.57, 95% CI 1.41−1.75). Moreover, elevated cardiac troponin levels were also significantly associated with increased hospital mortality of sepsis (HR = 1.35, 95% CI 1.19−1.53) and long‐term mortality of sepsis (HR = 1.96, 95% CI 1.51−2.55) using the random effects model. CONCLUSIONS: Overall, our finding revealed that elevated cardiac troponin for sepsis patients was a predictor of hospital and long‐term mortality. Clinicians may treat septic patients with elevated cardiac troponin more cautious to avoid extra death. Moreover, large clinical studies are warranted to validate this association.