Early elevation in plasma high-sensitivity troponin T and morbidity after elective noncardiac surgery: prospective multicentre observational cohort study
| Autor: | Gareth L. Ackland, Tom E.F. Abbott, Timothy F. Jones, Martin Leuwer, Rupert M. Pearse, Rupert Pearse, Edyta Niebrzegowska, Andrew Wragg, Andrew Archbold, Elisa Kam, Kirsty Everingham, Phoebe Bodger, Thais Creary, Ben Bloom, Alice Carter, Neil MacDonald, Nirav Shah, Katarzyna Mrozek, Amy Richardson, Alex Fowler, Zakaria Rob, Gareth Ackland, Robert Stephens, Anna Reyes, Laura Gallego Paredes, Pervez Sultan, David Cain, John Whittle, Mark Edwards, Simon Woldman, Ana Gutierrez del Arroyo, Shamir Karmali, Colin Williams, A. Rushton, I. Welters, Jane Parker, Robert J. Sapsford, Julian Barth, Julian Scott, Alistair Hall, Simon Howell, Michaela Lobley, Janet Woods, Susannah Howard, Joanne Fletcher, Nikki Dewhirst |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Critical Care Myocardial Infarction Kaplan-Meier Estimate Cardiovascular Sensitivity and Specificity Cohort Studies Primary outcome Postoperative Complications Troponin T Internal medicine medicine Cluster Analysis Humans cardiovascular diseases Postoperative Period Prospective Studies Aged Postoperative Care biology business.industry Organ dysfunction Perioperative Length of Stay Middle Aged High Sensitivity Troponin T Troponin United Kingdom Hospitalization Anesthesiology and Pain Medicine biology.protein Cardiology Observational study Female medicine.symptom Morbidity business Noncardiac surgery Biomarkers Cohort study |
| Zdroj: | Br J Anaesth |
| ISSN: | 1471-6771 |
| Popis: | BACKGROUND: Elevated high-sensitivity troponin (hsTnT) after noncardiac surgery is associated with higher mortality, but the temporal relationship between early elevated troponin and the later development of noncardiac morbidity remains unclear. METHODS: Prospective observational study of patients aged ≥45 yr undergoing major noncardiac surgery at four UK hospitals (two masked to hsTnT). The exposure of interest was early elevated troponin, as defined by hsTnT >99th centile (≥15 ng L(−1)) within 24 h after surgery. The primary outcome was morbidity 72 h after surgery, defined by the Postoperative Morbidity Survey (POMS). Secondary outcomes were time to become morbidity-free and Clavien–Dindo ≥grade 3 complications. RESULTS: Early elevated troponin (median 21 ng L(−1) [16–32]) occurred in 992 of 4335 (22.9%) patients undergoing elective noncardiac surgery (mean [standard deviation, sd] age, 65 [11] yr; 2385 [54.9%] male). Noncardiac morbidity was more frequent in 494/992 (49.8%) patients with early elevated troponin compared with 1127/3343 (33.7%) patients with hsTnT |
| Databáze: | OpenAIRE |
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