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

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

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Noordzij, P. G. Van Geffen, O. Dijkstra, I. M. Boerma, D. Meinders, A. J. Rettig, T. C. D. Eefting, F. D. Van Loon, D. Van De Garde, E. M. W. Van Dongen, E. P. A.
Description	Author Affiliation: Noordzij PG ( Department of Anaesthesia, Intensive Care and Pain Medicine p.noordzij@antoniusziekenhuis.nl.); van Geffen O ( Department of Anaesthesia, Intensive Care and Pain Medicine.); Dijkstra IM ( Department of Clinical Chemistry.); Boerma D ( Department of Surgery.); Meinders AJ ( Department of Internal Medicine.); Rettig TC ( Department of Anaesthesia, Intensive Care and Pain Medicine.); Eefting FD ( Department of Cardiology.); van Loon D ( Department of Clinical Chemistry.); van de Garde EM ( Department of Clinical Pharmacy, St Antonius Hospital, Koekoekslaan 1, 3430 EM, Nieuwegein, The Netherlands.); van Dongen EP ( Department of Anaesthesia, Intensive Care and Pain Medicine.)
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.
File Format	HTM / HTML
ISSN	00070912
e-ISSN	14716771
Journal	British Journal of Anaesthesia
Issue Number	6
Volume Number	114
Language	English
Publisher	Oxford University Press
Publisher Date	2015-06-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Anesthesiology Abdomen Surgery Myocardium Metabolism Postoperative Complications Blood Troponin T Cohort Studies Endpoint Determination Hospital Mortality Length Of Stay Odds Ratio Mortality Predictive Value Of Tests Prospective Studies Clinical Trial Observational Study Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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