Perioperative medicine & outcomes
Postoperative myocardial injury phenotypes and self-reported disability in patients undergoing noncardiac surgery: a multicentre observational study
Authors' conclusion
Although patients with postoperative myocardial injury had higher preoperative self-reported disability, disability scores did not change at 6 months after surgery. However, patients experiencing myocardial infarction worsened in disability score after surgery.
Study context
- Population
- Patients aged ≥50 yr undergoing elective major noncardiac surgery151 (17%) with postoperative myocardial injury (PMI)
- Participants
- 888 patients
- Exposure
- PMI phenotypes vs neither PMI nor adverse event
- Myocardial infarction (MI)n = 36
- Outcome
- Self-reported disability (WHO Disability Assessment Schedule 2.0 [WHODAS])
- Follow-up
- 6 months
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
Change in WHODAS disability score after surgery
- MI vs Neither PMI nor adverse event · worsened
- β 11.2 (95% CI 2.3–20.2)
- Adverse events without PMI vs Neither PMI nor adverse event · worsened
- β 8.1 (95% CI 3.0–13.2)
- Clinically silent PMI vs Neither PMI nor adverse event · no change
- β 1.39 (95% CI −4.50-7.29); P = 0.642
- PMI (any phenotype) vs No PMI · scores remained stable after surgery
- β 1.2 (95% CI −3.2-5.6)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Preoperative WHODAS disability score · Before surgeryPMI (any phenotype) vs No PMI | difference in WHODAS; β 3.3 (95% CI 0.5–6.2) |
| Preoperative WHODAS disability score · Before surgeryMI vs Neither PMI nor adverse event | β 5.5 (95% CI 0.3–10.8) |
Disability-free survival (WHODAS ≤16%) · 6 months
- Patients with 6-month disability-free survival
- 625 (71%)
Original publication
Postoperative myocardial injury phenotypes and self-reported disability in patients undergoing noncardiac surgery: a multicentre observational study. Br J Anaesth. Published 5 December 2023. doi:10.
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