Elevation of Troponin T in critically ill septic patients is common: but does it matter?
Bibliographic record
Abstract
Troponin T (TnT) is an established marker of adverse outcome in acute coronary syndrome patients and aids risk stratification. Myocardial dysfunction and elevated of TnT are common in critically ill patients and cardiology advice is often sought. To evaluate the role of TnT as a predictor of all-cause mortality in patients with severe sepsis/septic shock as defined by international criteria. A prospective observational study was performed on patients admitted to a general adult ICU within 24 hours of the development of severe sepsis/septic shock. Serial TnT samples were taken over the first 96 hours. Patients were grouped into three groups: A, TnT < 0.01 ng/ml; B, TnT 0.01–0.099 ng/ml; and C, TnT > 0.099 ng/ml. Blood from 49 patients was analysed. The peak Troponin level was elevated (>0.01 ng/ml) in 39/49 patients (80%). There was no significant difference between the three groups in terms of hypertension, history of angina, myocardial infarction or systolic blood pressure at time of ICU admission. Patients with undetectable TnT levels (<0.01 g/ml) had significantly lower 6-month mortality rates than those with detectable levels (group A 2/10 (20%) vs Group B/C 23/39 (59%), P = 0.037; group B 8/15 (53%), group C 15/24 (63%)). See Table 1 . Elevated biochemical markers of cardiac myocyte damage are common in patients with severe sepsis/septic shock. TnT elevation is a predictor of 6-month all-cause mortality. Clinicians should be aware of the significance of an elevated TnT assay in this patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".