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The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
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Myocardial Injury After Major Head and Neck Surgery.

Phillip Staibano1,2, Amit X Garg3,4,5, Matthew T V Chan6

  • 1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

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Summary

Myocardial injury after noncardiac surgery (MINS) is common in head and neck procedures, particularly in older patients. Early detection via troponin T monitoring is crucial as it significantly impacts 30-day mortality and hospital stay.

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Area of Science:

  • Cardiology
  • Oncology
  • Surgery

Background:

  • Myocardial injury after noncardiac surgery (MINS) is a known predictor of mortality.
  • The incidence and impact of MINS following major head and neck surgery are not well-established.

Purpose of the Study:

  • To determine the incidence of MINS in patients undergoing major head and neck surgery.
  • To assess the clinical implications and prognostic impact of MINS in this patient population.

Main Methods:

  • A cohort study utilizing data from the VISION study (N > 15,000 noncardiac surgery patients).
  • Included 648 patients undergoing major head and neck surgery, screened for MINS using troponin T (TnT) on postoperative days 1-3.
  • MINS defined by specific hsTnT levels or cardiac ischemia.

Main Results:

  • MINS incidence was 11.9% overall, increasing to 23.8% in patients aged 75+.
  • Nearly 70% of MINS cases were undetected without TnT monitoring.
  • MINS was associated with increased 30-day mortality (HR 5.51) and prolonged hospital stay in patients with ischemic features.

Conclusions:

  • Myocardial injury after noncardiac surgery is frequent in head and neck cancer patients, especially older individuals and those with comorbidities.
  • Troponin T monitoring is vital for detecting MINS, which is linked to adverse outcomes.
  • Further research is needed to validate MINS screening protocols for improved patient outcomes.