Cardiac Troponin I as a Prognostic Indicator of Mortality in Patients With Sepsis and Organ Dysfunction

Introduction and aim Sepsis is a complex, life-threatening condition characterized by systemic inflammation and multiorgan dysfunction. Elevated troponin levels (cTnI) have been associated with poor outcomes in sepsis; however, their role as a prognostic biomarker requires further investigation. This study aimed to (1) determine the association between elevated cardiac troponin I (>0.04 ng/mL) and 28-day mortality in patients with sepsis and organ dysfunction, and (2) evaluate the prognostic accuracy of troponin I for mortality prediction in this population. Methods We conducted a prospective cohort study involving 200 sepsis patients, measuring troponin levels at admission time and clinical and biochemical parameters, such as Sequential Organ Failure Assessment (SOFA) scores, D-dimer, and lactate. Data on organ dysfunction, coagulation abnormalities, and patient outcomes (mortality, length of ICU stay) were collected and analyzed. Results Troponin I levels were elevated in 69% of patients and were significantly associated with increased mortality (115 {83.4%} vs. 10 {16.2%}; p<0.001), longer ICU duration, and higher SOFA scores. Multivariate analysis revealed that elevated creatinine, low hemoglobin, increased CRP and alanine transaminase (ALT), neutrophilia, and reduced oxygen saturation were independent predictors of 28-day mortality. Troponin I showed high prognostic accuracy for mortality, and a cut-off value of >0.04 ng/mL demonstrated remarkable accuracy, achieving an AUC of 0.986 in receiver operating characteristic (ROC) analysis. Conclusion Troponin I serves as a readily accessible and prognostically significant biomarker that improves early risk assessment in patients experiencing sepsis with organ dysfunction.