Perioperative medicine & outcomes
Development and internal validation of models to predict postoperative troponin and myocardial injury after noncardiac surgery by incorporating hypotension as a predictor: single-centre retrospective cohort study
Authors' conclusion
A model including postoperative hypotension to predict postoperative troponin concentrations fits our data well, but did not show sufficient accuracy and is not ready for clinical practice.
Study context
- Population
- Patients aged ≥45 yr undergoing inpatient noncardiac surgery, St. Paul's Hospital, Canada, 2020–2021
- Participants
- 846 patients
- Outcome
- Maximum troponin concentration on PODs 1-3 (primary model)
- Follow-up
- PODs 1-3
Methodological detailssingle-centre, prediction model development and internal validation, repeated patient-based five-fold cross-validation with 100 repetitions
- Single-centre
- Prediction model development and internal validation
- Repeated patient-based five-fold cross-validation with 100 repetitions
Main finding
As reported in the abstract
Primary model for log-transformed troponin (internal validation)
Conditional R2
0.94
Marginal R2
0.20
Cross-validated root mean square error (RMSE)
0.90
Observational data: associations, not effects.
Further findings
MINS incidence between postoperative days (PODs) 0 and 3
- Patients developing MINS (299 of 846)
- 35%
MINS model (secondary model), internally validated
- AUC
- 0.69 (95% CI 0.63-0.75)
Inclusion of intraoperative hypotension
- Did not improve prediction of troponin or MINS
Original publication
Development and internal validation of models to predict postoperative troponin and myocardial injury after noncardiac surgery by incorporating hypotension as a predictor: single-centre retrospective cohort study. BJA Open. Published 28 July 2026. doi:10.
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