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Myocardial injury after noncardiac surgery and its association with short-term mortality

  • 0Department of Anesthesiology, University Medical Center Utrecht, Local Mail Q04.2.313, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Circulation +

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May 14, 2013

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May 14, 2013

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View abstract on PubMed

Summary

This summary is machine-generated.

Postoperative myocardial injury, detected by troponin elevation, independently predicts 30-day mortality in noncardiac surgery patients. Routine troponin monitoring may improve patient outcomes.

Area Of Science

  • Cardiology
  • Perioperative Medicine
  • Clinical Diagnostics

Background

  • Routine cardiac troponin monitoring is proposed for identifying patients at risk of death after noncardiac surgery.
  • This study evaluated the predictive value of troponin elevation for 30-day mortality.

Purpose Of The Study

  • To determine if postoperative myocardial injury, indicated by troponin levels, predicts 30-day mortality after noncardiac surgery.
  • To assess the feasibility and utility of implementing troponin monitoring as a standard of care.

Main Methods

  • An observational, single-center cohort study of 2232 intermediate- to high-risk noncardiac surgery patients aged ≥60 years.
  • Troponin I levels were measured on the first 3 postoperative days.
  • Log binomial regression analyzed the association between troponin elevation (>0.06 μg/L) and all-cause 30-day mortality.

Main Results

  • Postoperative myocardial injury was detected in 19% of patients (315/1627).
  • All-cause 30-day mortality occurred in 3% of patients (56/2232).
  • Elevated troponin levels significantly increased the risk of 30-day mortality (RR 2.4 for minor elevation, RR 4.2 for major elevation).

Conclusions

  • Postoperative myocardial injury is an independent predictor of 30-day mortality following noncardiac surgery.
  • Implementing routine troponin monitoring is feasible and may aid in improving patient prognosis.

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