Troponin elevation in subarachnoid hemorrhage does not impact 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.