The risk of post-operative myocardial injury after major emergency abdominal surgery: A retrospective cohort study
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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.
Original language | English |
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Journal | Acta Anaesthesiologica Scandinavica |
Volume | 64 |
Issue number | 8 |
Pages (from-to) | 1073-1081 |
Number of pages | 9 |
ISSN | 0001-5172 |
DOIs | |
Publication status | Published - 2020 |
Bibliographical note
© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
- Abdomen/surgery, Aged, Aged, 80 and over, Cohort Studies, Emergencies, Female, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Myocardial Infarction/epidemiology, New Zealand/epidemiology, Postoperative Complications/epidemiology, Retrospective Studies, Risk Assessment
Research areas
ID: 283365791