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Updated: May 15, 2026
Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Troponin elevation in subarachnoid hemorrhage does not impact in-hospital mortality
Manisha Gupte1, Sayona John, Shyam Prabhakaran
1Department of Neurological Sciences, Section of Cerebrovascular Disease and Neurological Critical Care, Rush University Medical Center, Chicago, IL 60612, USA.
Insights
Troponin I elevation is common in subarachnoid hemorrhage (SAH) but does not independently predict in-hospital mortality. Age and severe Hunt and Hess scores are key predictors of mortality in SAH patients.
Area of Science:
- Neurology
- Cardiology
- Critical Care Medicine
Background:
- Cardiac dysfunction is a recognized complication following subarachnoid hemorrhage (SAH).
- Elevated troponin levels are frequently observed in SAH patients.
- The prognostic significance of troponin abnormalities in SAH requires further investigation.
Purpose of the Study:
- To determine the frequency of troponin abnormalities in patients with subarachnoid hemorrhage.
- To assess the impact of elevated troponin levels on in-hospital mortality in SAH patients.
Main Methods:
- Retrospective review of 225 consecutive SAH patients (excluding traumatic cases).
- Data collection included demographics, Hunt and Hess score, in-hospital mortality, and peak troponin I levels.
- CT imaging was assessed for Fisher grade and intraventricular hemorrhage presence.
Main Results:
- Among 201 patients with troponin I values, 23% had elevated levels.
- Unadjusted analysis showed an association between elevated troponin I and in-hospital mortality.
- Multivariable analysis, adjusting for age, Hunt and Hess score, Fisher grade, and intraventricular hemorrhage, revealed troponin I elevation was not an independent predictor of mortality.
Conclusions:
- Troponin I elevation is not an independent predictor of in-hospital mortality in subarachnoid hemorrhage patients.
- Age and severe Hunt and Hess grade (4-5) were identified as independent predictors of in-hospital mortality.
Background:
Cardiac dysfunction is a well-known complication of subarachnoid hemorrhage (SAH). Our objective was to determine the frequency of troponin abnormalities in SAH and determine its impact on in-hospital mortality.
Methods:
With IRB approval, we retrospectively reviewed 225 consecutive SAH patients admitted to our institution from August 1, 2006 to June 1, 2009. Traumatic SAH patients were excluded. Data were collected on demographics, Hunt and Hess score (HH), in-hospital mortality, and peak troponin values on admission. CT images were independently reviewed and graded by the study neurologist for Fisher grade (FG) and the presence of intraventricular hemorrhage (IVH).
Results:
Among the 225 SAH patients, the mean age was 57.3 years (range, 21-90). The majority of patients were female (67%), FG 3 (75%), and had IVH (62%). Among the 201 patients with troponin I values, the mean troponin level was 0.93 (range, 0.01-25.8 ng/mL) and 47 (23%) had elevated troponin I levels. In unadjusted analysis, elevated troponin I level was significantly associated with in-hospital mortality. With multivariable logistic regression adjusting for age, HH, FG, and IVH, elevated troponin I level was no longer associated with in-hospital mortality (p. 0.34). In multivariate analysis, the independent predictors of in-mortality were age and severe grade HH (4-5).
Conclusions:
Troponin I elevation after SAH is not an independent predictor of in-hospital mortality.
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