Perioperative medicine & outcomes
Troponin elevation as a marker of short deterioration and one-year death in a high-risk surgical patient cohort in a low and middle income country setting: a postoperative approach to increase surveillance
Authors' conclusion
This study supports evidence that hsTnT is an important prognostic marker and a strong predictor of all-cause mortality after surgery.
Study context
- Population
- High-risk patients undergoing noncardiac surgery at a Brazilian hospital (LMIC), February 2019 to March 2020
- Participants
- 442 patients
- Exposure
- Postoperative high-sensitivity troponin T (hsTnT) minor elevation or major elevation vs normal
- Outcome
- All-cause mortality
- Follow-up
- One year
Methodological detailssingle-centre, hsTnT measured preoperatively, 24 hr and 48 hr after surgery
- Single-centre
- hsTnT measured preoperatively, 24 hr and 48 hr after surgery
Main finding
As reported in the abstract
One-year mortality
Each group vs normalHazard ratio (95% CI)
Minor elevation
1.94(1.22–3.09)
Major elevation
2.73(1.67–4.45)
Observational data: associations, not effects.
Further findings
- Unplanned intensive care unit (ICU) admission — Normal
- 5%
- Unplanned ICU admission: Altered troponin 13%
Postoperative myocardial injury
- Occurred in 45% of patients
30-day mortality
- Overall 30-day mortality
- 8%
- Higher with hsTnT ≥ 20 ng·L-1
Safety
- Complications — Normal
- 48%
- Complications: Altered troponin 78%
Original publication
Troponin elevation as a marker of short deterioration and one-year death in a high-risk surgical patient cohort in a low and middle income country setting: a postoperative approach to increase surveillance. Can J Anaesth. Published 18 October 2023. doi:10.
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