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Association between cardiac troponin I concentrations and electrocardiographic abnormalities in dogs with blunt trauma
Author(s) -
Biddick Allison A.,
Bacek Lenore M.,
Fan Shirley,
Kuo Kendon W.
Publication year - 2020
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12933
Subject(s) - medicine , troponin i , emergency department , triage , glasgow coma scale , troponin , blunt trauma , population , cardiology , anesthesia , emergency medicine , surgery , myocardial infarction , environmental health , psychiatry
Abstract Objective To determine whether a normal cardiac troponin I (cTnI) concentration and normal ECG on entry rule out the development of a clinically significant cardiac arrhythmia (CSCA, defined as an arrhythmia requiring anti‐arrhythmic treatment) in dogs that have sustained blunt trauma. Design Prospective, observational study. Client‐owned dogs were enrolled between January 2015 and November 2016. Setting University teaching hospital. Animals Forty‐seven client‐owned dogs with a history of witnessed or suspected blunt trauma within 24 hours prior to presentation to the hospital. Interventions On admission to the emergency service, dogs had a standard 3‐lead ECG and cTnI concentration (using a veterinary point‐of‐care device * ) performed. Animal Trauma Triage (ATT) scores, Modified Glasgow Coma Scale (MGCS), and the details regarding the nature and timing of the injury were recorded. The patients were monitored in the ICU for a minimum of 24 hours on continuous ECG telemetry. Cardiac rhythm was monitored every hour, and any abnormalities were noted. The need for anti‐arrhythmic therapy was recorded. There were no treatment interventions. Measurements and main results Five of 47 dogs (10.6%) developed a CSCA during hospitalization after sustaining blunt trauma. A normal entry ECG and normal cardiac troponin concentration on entry had a 100% negative predictive value (NPV) for ruling out the development of a CSCA, although a normal cardiac troponin concentration alone also had an NPV of 100%. A normal entry ECG had an NPV of 95.3%. The prognosis for survival to discharge was 89.4% in this study population (42/47 dogs). Conclusions In dogs with blunt trauma, an entry cTnI concentration or a combination of cTnI and ECG on entry may be useful in determining which patients are at a higher risk for the development of CSCA during the first 12 to 24 hours after the trauma.