Pathological Troponin concentration elevation occurs in 7% of all trauma patients and it identifies the seriously injured high-risk cohort with worse outcomes than expected based on injury severity.

The timing of the maximum Troponin concentration seems to describe three distinct phenotypes. “Hyperacute”, which is seemingly a self-limiting process with most favorable outcomes; “Subacute” with severe trauma and tissue injury requiring major resource utilization and associated with the highest mortality rate; and “Late” characterized by ECG and ECHO changes suggesting primary ischemic cardiac pathology.

This descriptive study provides essential information for future prospective studies investigating the significance of myocardial injury in the trauma population.

We suggest further characterization of the proposed phenotypes with aims to individualize their management for optimal outcomes.

From 1,408 admissions, 97(7%) patients [Age:57(35,80); Male:71%; ISS:18(9–33); LOS:9(4,16.5); ICU:66%; Mortality:16.5%] had elevated Troponin.

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