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The risk of post-operative myocardial injury after major emergency abdominal surgery: A retrospective cohort study.

Authors :
Ekeloef, Sarah
Bjerrum, Ellen
Kristiansen, Puk
Wahlstrøm, Kirsten
Burcharth, Jakob
Gögenur, Ismail
Source :
Acta Anaesthesiologica Scandinavica; Sep2020, Vol. 64 Issue 8, p1073-1081, 9p, 1 Diagram, 5 Charts, 1 Graph
Publication Year :
2020

Abstract

<bold>Background: </bold>The aim was to examine the risk of post-operative myocardial injury after major emergency abdominal surgery and identify pre- and intra-operative risk factors of post-operative myocardial injury. Moreover, the study aimed to examine the association between post-operative myocardial injury and clinical outcomes.<bold>Methods: </bold>This was a retrospective cohort study including patients undergoing major emergency abdominal surgery from February 2017 to January 2019. Troponin I was assessed on post-operative days 1-3. Post-operative myocardial injury was defined as a cardiac troponin I ≥ 45 ng per litre. Post-operative clinical outcomes included in-hospital myocardial infarction, in-hospital major adverse cardiovascular events, reoperation, admission to the intensive care unit, lengths of stay, 30- and 90-day all-cause mortality.<bold>Results: </bold>98 out of 401 patients (24.4%) sustained a post-operative myocardial injury within the third post-operative day. Increasing age was an independent risk factor of post-operative myocardial injury (age per 10 years adjusted odds ratio 2.2 [95% CI 1.7-2.9], P < .0001). Patients with post-operative myocardial injury had an increased risk of major adverse cardiovascular events, a higher admission rate to the intensive care unit, a longer median post-operative length of stay and a higher 30- and 90-day all-cause mortality compared with patients without myocardial injury.<bold>Conclusion: </bold>One in four patients suffered a post-operative myocardial injury within the third post-operative day. Post-operative myocardial injury was a risk factor of adverse cardiac and non-cardiac clinical outcomes. Troponin monitoring could potentially improve the post-operative risk stratification in this cohort of high-risk surgical patients. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00015172
Volume :
64
Issue :
8
Database :
Complementary Index
Journal :
Acta Anaesthesiologica Scandinavica
Publication Type :
Academic Journal
Accession number :
144948987
Full Text :
https://doi.org/10.1111/aas.13622