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Intraoperative high-sensitivity troponin elevation predicts severe postoperative complications after liver
Patricia Duque1, Mar Rueda2, Almudena L Vilchez-Monge3
1Medical Faculty, Universidad Alfonso X El Sabio, Madrid, Spain; Department of Anesthesiology and Intensive Care, Hospital General Universitario Gregorio Marañon, Madrid, Spain; Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain.
Background:
We aim to evaluate the association between intraoperative increases in high-sensitivity cardiac troponin I (hs-cTnI) and severe postoperative complications (sPOC), defined as Clavien-Dindo grade IV or V, within the first four weeks after liver transplantation.
Methods:
The study included 233 patients who were stratified based on whether hs-cTnI levels at the end of surgery were above the 99th percentile.
Results:
The incidence of sPOC was significantly higher in patients with cTE (29.2% vs. 11.8%; p = 0.001), who also had a higher incidence of respiratory failure (p = 0.015), acute kidney injury (p < 0.001), renal replacement therapy (p = 0.001), and re-interventions within four weeks (p = 0.028). Multivariate analysis identified hs-cTnI levels as independent predictor of sPOC (OR: 2.70[1.14-6.40], p = 0.005).
Conclusions:
Intraoperative hs-cTnI elevation was independently associated with sPOC. These must be interpreted in the context of the observational study design and the possibility of residual confounding.
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