The risk of post-operative myocardial injury after major emergency abdominal surgery: A retrospective cohort study
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The risk of post-operative myocardial injury after major emergency abdominal surgery : A retrospective cohort study. / Ekeloef, Sarah; Bjerrum, Ellen; Kristiansen, Puk; Wahlstrøm, Kirsten; Burcharth, Jakob; Gögenur, Ismail.
In: Acta Anaesthesiologica Scandinavica, Vol. 64, No. 8, 2020, p. 1073-1081.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The risk of post-operative myocardial injury after major emergency abdominal surgery
T2 - A retrospective cohort study
AU - Ekeloef, Sarah
AU - Bjerrum, Ellen
AU - Kristiansen, Puk
AU - Wahlstrøm, Kirsten
AU - Burcharth, Jakob
AU - Gögenur, Ismail
N1 - © 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2020
Y1 - 2020
N2 - BACKGROUND: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.
AB - BACKGROUND: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.
KW - Abdomen/surgery
KW - Aged
KW - Aged, 80 and over
KW - Cohort Studies
KW - Emergencies
KW - Female
KW - Humans
KW - Length of Stay/statistics & numerical data
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/epidemiology
KW - New Zealand/epidemiology
KW - Postoperative Complications/epidemiology
KW - Retrospective Studies
KW - Risk Assessment
U2 - 10.1111/aas.13622
DO - 10.1111/aas.13622
M3 - Journal article
C2 - 32407553
VL - 64
SP - 1073
EP - 1081
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 8
ER -
ID: 283365791