Abstract:
BACKGROUND:Patients undergoing non-cardiac, non-vascular surgery are at risk of major cardiovascular complications. In non-cardiac surgery, troponin elevation has previously been shown to be an independent predictor of major adverse cardiac events and postoperative mortality; however, a majority of studies have focused on vascular surgery patients. The aim of this meta-analysis was to determine whether troponin elevation is a predictor of major adverse cardiac events and mortality within 30 days and 1 yr after non-cardiac, non-vascular surgery. METHODS:A systematic review and meta-analysis was conducted in January 2016 according to the Meta-analysis Of Observational Studies in Epidemiology guidelines. Both interventional and observational studies measuring troponin within the first 4 days after surgery were eligible. A systematic search was performed in PubMed, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials. RESULTS:Eleven eligible clinical studies (n=2193) were identified. A postoperative troponin elevation was a predictor of 30 day mortality, odds ratio (OR) 3.52 [95% confidence interval (CI) 2.21-5.62; I2=0%], and an independent predictor of 1 yr mortality, adjusted OR 2.53 (95% CI 1.20-5.36; I2=26%). A postoperative troponin elevation was associated with major adverse cardiac events at 30 days, OR 5.92 (95% CI 1.67-20.96; I2=86%), and 1 yr after surgery, adjusted OR 3.00 (95% CI 1.43-6.29; I2=21%). CONCLUSIONS:Postoperative myocardial injury is an independent predictor of major adverse cardiac events and mortality within 30 days and 1 yr after non-cardiac, non-vascular surgery. The meta-analysis provides evidence that supports troponin monitoring as a cardiovascular risk stratification tool.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Ekeloef S,Alamili M,Devereaux PJ,Gögenur Idoi
10.1093/bja/aew321subject
Has Abstractpub_date
2016-11-01 00:00:00pages
559-568issue
5eissn
0007-0912issn
1471-6771pii
S0007-0912(17)30013-2journal_volume
117pub_type
杂志文章,meta分析,评审abstract::We have compared, in a randomized study in 26 patients, immediate and late postoperative recovery after elective laparoscopic cholecystectomy using the gasless, mechanical abdominal wall lift method with conventional carbon dioxide pneumoperitoneum. After the gasless method, tracheal extubation was performed significa...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/77.5.576
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Using a carrageenan inflammation rat model, we evaluated two experimental approaches to prolong sciatic nerve block on contralateral hyperalgesia. Method. We performed ipsilateral sciatic nerve block on the inflamed hind paw with bupivacaine-loaded microspheres suspended in dexamethasone (bupivacaine 12.5 mg...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh264
更新日期:2004-11-01 00:00:00
abstract::This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief, Professor Hugh Hemmings, based on the recommendations of Justus-Liebig-University Giessen f...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,撤回出版物
doi:10.1016/j.bja.2020.07.036
更新日期:2020-09-01 00:00:00
abstract::Volatile anaesthetics have been shown to have direct relaxant effects on airway smooth muscle. We have examined the effects of 0.9, 1.9, and 2.8 dog MAC of desflurane and halothane on isolated proximal and distal canine airways precontracted with acetylcholine. The proximal and distal airway smooth muscle relaxed with...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.6.841
更新日期:1996-06-01 00:00:00
abstract::BW 403C65, an isoquinolinium bisquaternary compound, was investigated for its neuromuscular blocking properties. In vitro in from preparations, low concentrations induced an increase in miniature endplate potentials (m.e.p.p.) frequency without altering their amplitude. With increasing concentrations m.e.p.p. frequenc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.9.929
更新日期:1975-09-01 00:00:00
abstract:BACKGROUND:Plasma-free volume replacement in haemorrhage often results in dilutional coagulopathy. Prothrombin time index (PTI) and activated partial thromboplastin time (aPTT) are used for monitoring haemostasis but have not yet been clinically evaluated. Our aim was to investigate the effects of haemodilution on the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq199
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Brachytherapy presents the anaesthetist with unique problems. Information on anaesthesia for brachytherapy, however, is limited. The aim of this paper is to report on our experience involving a large number of brachytherapy procedures. METHODS:A retrospective analysis of records of 1622 anaesthetic procedur...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei301
更新日期:2006-02-01 00:00:00
abstract::Amethocaine 1% solution was mixed with equal volumes of water, 0.9% saline or 10% dextrose to prepare respectively, hypobaric, isobaric and hyperbaric solutions which were compared for intradural spinal anaesthesia in 60 patients. Thirty patients received 10 mg and 30 patients received 15 mg of amethocaine. Injections...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/52.6.589
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Anaesthetics blunt neuronal responses to noxious stimulation, including effects on electroencephalographic (EEG) responses. It is unclear how anaesthetics differ in their ability to modulate noxious stimulation-evoked EEG activation. We investigated the actions of propofol and halothane on EEG responses to n...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei208
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Left ventricular (LV) pressure-volume (PV) loops were used to compare the functional effects that accompany the cardioprotection seen with desflurane, sevoflurane, and propofol in a rabbit preparation of coronary ischaemia-reperfusion (IR). METHODS:Male New Zealand White rabbits (n=48) were anaesthetized wi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep238
更新日期:2009-11-01 00:00:00
abstract::We studied 133 women given a combined spinal-epidural for analgesia in labour. The initial intrathecal dose contained bupivacaine 2.5 mg with fentanyl 25 micrograms. When the mothers were comfortable, they were allocated randomly to one of three groups: continuous infusion (group Cl, n = 46), midwife top-ups (group MW...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.2.233
更新日期:1999-02-01 00:00:00
abstract::Cumulation and interaction of neuromuscular blocking effects of neomycin and tubocurarine were determined on responses of the tibialis anterior muscle of the anaesthetized cat to indirect stimulation. Neuromuscular block produced by neomycin was cumulative despite rapid and apparent full recovery of twitch tension and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.6.571
更新日期:1981-06-01 00:00:00
abstract::We have determined the influence of 0.1 minimum alveolar concentration (MAC) of sevoflurane on ventilation, the acute ventilatory response to a step change in end-tidal carbon dioxide and the ventilatory response to sustained hypercapnia in 10 healthy adult volunteers. Subjects undertook a preliminary 10-min period of...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/83.2.204
更新日期:1999-08-01 00:00:00
abstract::This review describes the laboratory evidence and microvascular mechanisms responsible for the beneficial effects of statins in sepsis. During sepsis, changes occur within the microcirculation including alterations in arteriolar tone influencing blood pressure, adaptations to endothelial cell integrity causing leakage...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/ael358
更新日期:2007-02-01 00:00:00
abstract::We describe the management of a patient with Eisenmenger's syndrome presenting for laparoscopic cholecystectomy. Of prime concern was maintenance of systemic vascular resistance and this was achieved using infusion of noradrenaline started before induction of anaesthesia and continued after operation. Avoidance of oth...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.6.810
更新日期:1997-12-01 00:00:00
abstract::A 39-year-old male suffered a closed chest deceleration injury. He presented with clinical and radiological signs consistent with trauma to the thoracic aorta, but also developed sinus bradycardia which was relieved by drainage of a haemothorax. The possible mechanisms of the changes in heart rate are discussed and di...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.3.358
更新日期:1994-03-01 00:00:00
abstract::When using endobronchial anaesthesia for the management of transthoracic endoscopic sympathectomy (TES), excessive insufflation of carbon dioxide into the pleural space may cause haemodynamic instability, hypoxaemia and tension pneumothorax. We prospectively studied an alternative technique using a tracheal tube, i.v....
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/74.2.141
更新日期:1995-02-01 00:00:00
abstract::The kinetics of morphine were studied during balanced anaesthesia in 10 patients undergoing lower abdominal or body surface surgery, and compared with those obtained in nine awake patients receiving morphine i.v. for the relief of chronic non-cancer pain. All patients received morphine sulfphate pentahydrate 10 mg i.v...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.1.22
更新日期:1989-01-01 00:00:00
abstract::Intravenous dose-response relationships for dimethyl tubocurarine showed that vagal blockade only became appreciable (50-83%) at doses 8-16 times those sufficient for full neuromuscular paralysis in anaesthetized cats (0.0625 mg/kg) and rhesus monkeys (0.125 mg/kg); heart rate was unchanged. Sympathetic function was u...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.9.847
更新日期:1976-09-01 00:00:00
abstract:INTRODUCTION:Patients with hip fractures are usually frail and elderly with a 30-day mortality in excess of 10% in European series. Perioperative morbidity is often multifactorial in nature, and unimodal interventions will not necessarily decrease mortality. The purpose of this prospective study was to analyse causes o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei010
更新日期:2005-01-01 00:00:00
abstract::We calculated oxygen consumption by the reverse Fick principle (cVO2) using cardiac output measured with a new technique of continuous thermal dilution and compared these values with measurements made at the same time using a gas exchange method (mVO2). We studied nine patients in a stable condition after cardiac surg...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/75.6.719
更新日期:1995-12-01 00:00:00
abstract::Intrathecal midazolam causes antinociception by combining with spinal cord benzodiazepine receptors. This effect is reversible with doses of naloxone, suggesting involvement of spinal kappa or delta but not mu opioid receptors. The antinociceptive effects of intrathecally administered drugs in the spinal cord were dem...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.6.758
更新日期:1996-12-01 00:00:00
abstract::In the prone knee-chest position the spread of plain 0.5% bupivacaine in the cerebrospinal fluid and associated haemodynamic changes may be different compared with the horizontal position. A randomized comparison was performed in 40 ASA I-II patients, aged 24-61 yr, undergoing lumbar disc surgery. Subarachnoid injecti...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/79.5.609
更新日期:1997-11-01 00:00:00
abstract::In this study, we simultaneously evaluated the spasmolytic effects of prostaglandin E1 (PGE1) on serotonin-induced bronchoconstriction and pulmonary hypertension. Eleven mongrel dogs (8-12 kg) anaesthetized with pentobarbital were assigned to two groups: saline (n = 4) and PGE1 (n = 7). Bronchoconstriction and pulmona...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.3.460
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Better education of clinicians is expected to enhance patient safety. An important component of education is adherence to standard protocols, which are mainly available in written form. Believing in the potential power of videos, we hypothesized that the introduction of an educational video, based on an inst...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew030
更新日期:2016-05-01 00:00:00
abstract::We have investigated the effect of dopamine and dopexamine on the isolated perfused rat kidney. After an equilibration period of 20 min and two control periods of 10 min, dopexamine 1.0, 2.5 or 4.0 micrograms kg-1 min-1 or dopamine 2.0 micrograms kg-1 min-1 were perfused for a further 40 min in random order. Renal blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.898
更新日期:1999-12-01 00:00:00
abstract::A genetic disorder of the calcium releasing ryanodine receptor has recently been postulated in malignant hyperthermia (MH) and ryanodine-induced contractures differ between subjects who are malignant hyperthermia susceptible (MHS) and non-susceptible (MHN). We tested 39 patients from 26 families for MH, using the proc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.2.242
更新日期:1993-08-01 00:00:00
abstract::Twenty consecutive patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were allocated at random to group 1 (n = 10, high inspired oxygen fraction (FIO2) after CPB), or group 2 (n = 10, moderate FIO2 after CPB). The effects of each FIO2 on arterial and mixed venous concentrations of endothelin-1 (ET-1...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/84.5.565
更新日期:2000-05-01 00:00:00
abstract::The anaesthetist's work, aimed at giving safe anaesthesia to patients, can do both harm and good to the anaesthetist. Research on stress in anaesthesia has traditionally focused on how the negative effects of stress can be avoided and much effort has been put into improving anaesthetists' work environment to reduce th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeq125
更新日期:2010-07-01 00:00:00
abstract::The effects of different premedication (i.m. and i.v.) on the usefulness of midazolam or thiopentone as induction agents for minor surgery was studied in 194 women undergoing either dilatation and curettage or explorative fractionate curettage. Midazolam appeared to produce light sedation which required powerful preme...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/54.5.507
更新日期:1982-05-01 00:00:00