Value of Addition of Troponin I to APACHE II Scoring System in Sepsis for Prediction of Mortality Rate in Medical Intensive Care Unit

Background: The APACHE score demonstrates a high degree of precision and specificity through the assessment of patient cohorts utilizing established mortality rate ratios.Aim of the work: To determine whether the addition of Troponin I to the APACHE II score in sepsis improves the ability to predict death in the medical intensive care unit (MICU).Patients and methods: This prospective cross-sectional observational study was carried out on 103 adult patients older than 18 years who were admitted to the MICU within the first 24 hours and provided oral consent directly or through their relatives. Grouping: All subjects were divided into 2 groups: Group I (n= 27): Included hospital mortality patients, and Group II (n= 76): Included alive patients. All patients underwent a full clinical evaluation, vital signs and physiological measurements taken within the first 24 hours, and laboratory investigations.Results: The combination of (TnI at cut off value 0.8200) and (APACHE at cut off value 30.0) showed a sensitivity of 81.5% and a specificity of 61.9%, with an AUC of 0.717 (95% CI: 0.593–0.841). This indicates a moderate but statistically significant ability to predict hospital mortality (p = 0.002). Conclusions: Both Troponin I and APACHE II scores are significant predictors of mortality in septic ICU patients; combining them does not enhance predictive accuracy beyond APACHE II alone. APACHE II remains an excellent standalone tool for mortality prediction in this population. Troponin I, despite its strong association with mortality, loses independent predictive value when considered alongside comprehensive severity-of-illness scores.