This 5-year retrospective study evaluated whether initial and serial serum troponin levels independently predict adverse cardiac events in stable adult trauma patients admitted with suspected blunt cardiac injury (BCI) or sternal fracture (SBP ≥90 mmHg, HR <110 bpm, shock index <1, GCS ≥14) at a Level I Trauma Center.
Among 350 stable patients, only 12 adverse cardiac events occurred (all new arrhythmias requiring treatment). No adverse events occurred in the 83 patients with a normal ECG but abnormal troponin. Only 1 adverse event occurred among 160 patients with both normal ECG and troponin. Abnormal ECG — not troponin — was the significant predictor of adverse events (p <0.001).
Retrospective single-center design limits generalizability. The low event rate (12/350) may underpowered subgroup analyses. Study excluded hemodynamically unstable patients, so findings apply only to the stable admitted cohort.
In hemodynamically stable admitted patients at risk for BCI, serum troponin did not add predictive value beyond ECG alone. Clinicians may consider omitting serial troponin monitoring in this population when the ECG is normal, potentially simplifying care.
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