Impact of addition of Troponin I to APACHE II score on its Predictive Value of Mortality in Medical Intensive Care Patients

Background: In 1981, the APACHE scoring system was initially developed to forecast the outcome for patients admitted to the intensive care unit. And then, in the subsequent two decades, there were subsequent versions including APACHE II, III, and IV systems. Aim and objectives: The purpose of this study is to determine whether the Damanhur Medical National Institute in Damanhur, Egypt's non-surgical critical care unit patients' risk of death may be improved by including Troponin I as a criterion in the APACHE II score. Patients and methods: From March 2023 to March 2024, this prospective study was conducted in the intensive care department of the Damanhur Medical National Institute, involving 200 patients who were admitted to the intensive care unit(ICU) for medical reasons. Results: Around 75% of the cases that died had positive troponin levels, while 78% of the cases that lived had negative levels. This difference in troponin levels is statistically significant (p-value<0.05). Conclusion: In terms of APACHE score and APACHE percentage, there was a statistically significant distinction between cases where Troponin was positive and those where it was negative. The Addition of Troponin I levels to the APACHE II score results in an approximate 11.25% improvement in predictive value.