Background cardiac dysfunction is frequently observed after severe traumatic brain injury (sTBI), however its significance is poorly understood. Our study sought to elucidate the association of cardiac troponin I (cTnI) elevation with all cause in-hospital mortality following isolated sTBI (brain AIS ≥ 3 and admission GCS ≤ 8, no AIS ≥3 to any other bodily regions). Methods we retrospectively reviewed all adult patients (≥ 18 years) with isolated sTBI admitted to a level one trauma center between June 2007 and January 2014. Patients must have cTnI values within 24 hours of admission. Mortality risks were examined by Cox proportional hazard model. Results of the 580 patients identified, 30.9% had detectable cTnI in 24 hours of admission. The median survival time was 4.19 days (IQR: 1.27 – 11.69). When adjusted for potential confounders, patients in the highest cTnI category (≥ 0.21 ng/mL) had significantly higher risk of in-hospital mortality (HR: 1.39; 95% CI: 1.04 – 1.88) compared to patients with undetectable cTnI. Mortality risk increased with higher troponin levels (p-trend < 0.0001). This association was more pronounced in patients ≤65 years (HR: 2.28; 95% CI: 1.53 – 3.40; p-trend < 0.0001), while interestingly, insignificant in those > 65 years (p-trend = 0.0826). Conclusions among patients with sTBI, cTnI elevation is associated with all cause in-hospital mortality via a non-linear, positive trend. Age modified the effect of cTnI on mortality. Level of Evidence level III retrospective study, Prognostic and Epidemiological

No abstract

Therapeutic study, level IV.