In this small single institution study of 159 bacteremic patients, all of which had troponin I sent, 43% were elevated (abstract). Most were minor elevations (96% < 1mcg/L). Not surprisingly, independent risk factors for troponin elevations included renal insufficiency, higher WBC, and septic shock. Troponin elevations were not significantly associated with EKG changes (although not performed in all patients), and did not independently predict mortality. For bacteremic patients, if you check troponin, there is about a coin-toss chance it will be elevated, but given the lack of association with EKG changes or mortality, there is no clear benefit of routinely checking it in the first place.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.