Association of CRP/Troponin Ratio with Mortality in Pneumosepsis Patients Admitted from the Emergency Department

Öz

Objective: This study aimed to investigate the association between the C-reactive protein (CRP)/troponin ratio at Intensive Care Unit (ICU) admission and mortality in patients with pneumosepsis admitted from the emergency department (ED). Materials and Methods: This retrospective, single-center cohort study included 40 adult patients admitted to the ICU with pneumosepsis between September 2024 and September 2025. Demographics, comorbidities, admission laboratory data (including CRP, troponin, and other biomarkers), disease severity scores (APACHE II, SOFA), need for respiratory support, inotrope use, and ICU outcomes were collected from electronic medical records. Patients were stratified into survivor and non-survivor groups. Continuous variables were compared using the Mann–Whitney U test, and categorical variables with the chi-square or Fisher’s exact test. Results: ICU mortality occurred in 23 patients (57.5%), whereas 17 patients (42.5%) survived to hospital discharge. The CRP/troponin ratio was significantly lower in non-survivors (3.7 [IQR: 1.4–8.7]) compared to survivors (8.9 [IQR: 4.0–51.8], p = 0.006). Troponin levels were significantly higher in non-survivors (24.4 vs. 9.7 ng/L, p = 0.005). Non-survivors required longer invasive mechanical ventilation (p < 0.001) and had greater inotrope use (p = 0.004). APACHE II and SOFA scores were higher in non-survivors but did not reach statistical significance. Conclusion: A lower CRP/troponin ratio at ICU admission was strongly associated with mortality in ED-admitted pneumosepsis patients. This ratio may represent a simple and readily available prognostic tool that could improve early risk stratification and guide management strategies.

Anahtar Kelimeler

• sepsis
• Pneumonia
• Troponin
• C-Reactive Protein
• Mortality

Acil Servisten Yatırılan Pnömosepsis Hastalarında CRP/Troponin Oranının Mortalite ile İlişkisi

Öz

Amaç: Bu çalışmada, acil servisten yoğun bakıma yatırılan pnömosepsis hastalarında yoğun bakım yatışı sırasında ölçülen C-reaktif protein (CRP)/troponin oranının mortalite ile ilişkisi araştırıldı. Gereç ve Yöntem: Bu retrospektif, tek merkezli kohort çalışmasına Eylül 2024 – Eylül 2025 tarihleri arasında pnömosepsis tanısı ile yoğun bakıma kabul edilen 40 erişkin hasta dahil edildi. Demografik özellikler, komorbiditeler, giriş laboratuvar verileri (CRP, troponin ve diğer biyobelirteçler), hastalık şiddet skorları (APACHE II, SOFA), solunum desteği gereksinimleri, inotrop kullanımı ve yoğun bakım sonuçları elektronik hasta kayıtlarından elde edildi. Hastalar yaşayan ve ölenler olarak iki gruba ayrıldı. Sürekli değişkenler Mann–Whitney U testi, kategorik değişkenler ki-kare veya Fisher’s exact testi ile karşılaştırıldı. Bulgular: Yoğun bakım mortalitesi 23 hastada (%57,5) gerçekleşti; 17 hasta (%42,5) taburcu oldu. CRP/troponin oranı ölenlerde anlamlı olarak daha düşüktü (3,7 [IQR: 1,4–8,7] vs. 8,9 [IQR: 4,0–51,8], p = 0,006). Troponin düzeyleri ölenlerde anlamlı olarak yüksekti (24,4 vs. 9,7 ng/L, p = 0,005). Ölen hastalarda invaziv mekanik ventilasyon süresi daha uzundu (p < 0,001) ve inotrop gereksinimi daha fazlaydı (p = 0,004). APACHE II ve SOFA skorları daha yüksek olmasına rağmen istatistiksel olarak anlamlı bulunmadı. Sonuç: Yoğun bakım yatışı sırasında düşük CRP/troponin oranı, acil servisten yatırılan pnömosepsis hastalarında mortalite ile güçlü şekilde ilişkili bulundu. Bu oran, erken risk sınıflaması ve yönetim stratejilerini yönlendirmek için basit ve erişilebilir bir prognostik araç olarak kullanılabilir.

Anahtar Kelimeler

• sepsis
• pnömoni
• troponin
• C-reaktif protein
• mortalite

Kaynakça

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