High-Sensitivity Troponin T as a Predictor of Prolonged Intensive Care Unit Stay and Worse Treatment Outcomes in...

Background: Prolonged stays in the postoperative intensive care unit (ICU) for patients undergoing heart valve surgery are mainly caused by the development of complications. In turn, with the extension of the ICU stay, there is a risk of developing further serious postoperative complications. The main aim of the present study was to evaluate selected biomarkers in terms of their predictive potential for a prolonged postoperative stay in the ICU. Methods: This prospective study was conducted on a group of patients undergoing heart valve surgery. The primary endpoint was prolonged postoperative intensive care unit stay beyond 3 days (above the median). Logistic regression analysis was used to assess the predictors of the occurrence of the primary endpoint. Results: A total of 631 patients were included in the study. The median stay in the ICU was 3 days (2-5). A total of 265 patients required a prolonged stay in the ICU. In multivariate logistic regression analysis troponin T measured before surgery (p = 0.014), EuroSCORE II operative risk score (p = 0.004), troponin T measured the day after surgery (p = 0.005), preoperative RDW level (p = 0.005) and the presence of preoperative atrial fibrillation (p = 0.002) were independent predictors of the primary endpoint. Conclusions: Patients with elevated troponin T values determined both before the procedure and in the early postoperative period should be given special attention, because this group of patients is burdened with an increased risk of prolonged stay in the postoperative ward, the occurrence of serious postoperative complications and ultimately worse prognosis.