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High-sensitive cardiac troponin T measurements in prediction of non-cardiac complications after major abdominal surgery.

Abstract：

BACKGROUND:Postoperative non-cardiac complication rates are as high as 11-28% after high-risk abdominal procedures. Emerging evidence indicates that postoperative cardiac troponin T elevations are associated with adverse outcome in non-cardiac surgery. The aim of this study was to determine the relationship between postoperative high-sensitive cardiac troponin T elevations and non-cardiac complications in patients after major abdominal surgery. METHODS:This prospective observational single-centre cohort study included patients at risk for coronary artery disease undergoing elective major abdominal surgery. Cardiac troponin was measured before surgery and at day 1, 3, and 7. Multivariable logistic regression analysis was performed to examine the adjusted association for different cut-off concentrations of postoperative myocardial injury and non-cardiac outcome. RESULTS:In 203 patients, 690 high-sensitive cardiac troponin T measurements were performed. Fifty-three patients (26%) had a non-cardiac complication within 30 days after surgery. Hospital mortality was 4% (8/203). An increase in cardiac troponin T concentration ≥100% compared with baseline was a superior independent predictor of non-cardiac postoperative clinical complications (adjusted odds ratio 4.3, 95% confidence interval 1.8-10.1, P<0.001) and was associated with increased length of stay (9 days, 95% confidence interval 7-11 vs 7 days, 95% confidence interval 6-8, P=0.004) and increased hospital mortality (12 vs 2%, P=0.028). CONCLUSIONS:A postoperative high-sensitive cardiac troponin T increase ≥100% is a strong predictor of non-cardiac 30 day complications, increased hospital stay and hospital mortality in patients undergoing major abdominal surgery. CLINICALTRIALSGOV IDENTIFIER:NCT02150486.

journal_name

Br J Anaesth

journal_title

British journal of anaesthesia

authors

Noordzij PG,van Geffen O,Dijkstra IM,Boerma D,Meinders AJ,Rettig TC,Eefting FD,van Loon D,van de Garde EM,van Dongen EP

doi

10.1093/bja/aev027

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

909-18

issue

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)31475-7

journal_volume

114

pub_type

临床试验,杂志文章

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High-sensitive cardiac troponin T measurements in prediction of non-cardiac complications after major abdominal surgery.