Article ; Online: Addition of High-Sensitivity Troponin to Perioperative Risk Assessment Improves the Predictive Ability of Death in Non-Cardiac Surgery Patients.
Arquivos brasileiros de cardiologia
2024 Volume 121, Issue 4, Page(s) e20230623
Abstract: Background: Risk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables.: Objective: Evaluate the incremental power of troponin to the usual risk ... ...
| Title translation | Adição da Troponina Ultrassensível à Avaliação de Risco Perioperatório Melhora a Capacidade Preditiva de Morte em Pacientes Submetidos à Cirurgia Não Cardíaca. |
|---|---|
| Abstract | Background: Risk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables. Objective: Evaluate the incremental power of troponin to the usual risk stratification. Methods: A total of 2,230 patients admitted to the intensive care unit after non-cardiac surgery were classified according to three types of risk: cardiovascular risk (CVR), Revised Cardiac Risk Index (RCRI); and inherent risk of surgery (IRS). The main outcome was all-cause mortality. Cox regression was used as well as c-statistics before and after addition of high-sensitivity troponin (at least one measurement up to three days after surgery). Finally, net reclassification index and integrated discrimination improvement were used to assess the incremental power of troponin for risk stratification. Significance level was set at 0.05. Results: Mean age of patients was 63.8 years and 55.6% were women. The prevalence of myocardial injury after non-cardiac surgery (MINS) was 9.4%. High CVR-patients had a higher occurrence of MINS (40.1 x 24.8%, p<0.001), as well as high IRS-patients (21.3 x 13.9%, p=0.004) and those with a RCRI≥3 (3.0 x 0.7%, p=0.009). Patients without MINS, regardless of the assessed risk, had similar mortality rate. The addition of troponin to the risk assessment improved the predictive ability of death at 30 days and at 1 year in all risk assessments. Conclusion: The prevalence of MINS is higher in the high-risk population. However, its prevalence in lower-risk population is not negligible and causes a higher risk of death. The addition of high-sensitivity troponin increased the predictive ability of risk assessment in all groups. |
| MeSH term(s) | Humans ; Female ; Male ; Middle Aged ; Risk Assessment/methods ; Biomarkers/blood ; Aged ; Troponin/blood ; Risk Factors ; Perioperative Period ; Predictive Value of Tests ; Surgical Procedures, Operative/mortality ; Surgical Procedures, Operative/adverse effects ; Time Factors ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/blood ; Postoperative Complications/mortality ; Postoperative Complications/blood |
| Chemical Substances | Biomarkers ; Troponin |
| Language | English |
| Publishing date | 2024-05-08 |
| Publishing country | Brazil |
| Document type | Journal Article |
| ZDB-ID | 730261-7 |
| ISSN | 1678-4170 ; 0066-782X |
| ISSN (online) | 1678-4170 |
| ISSN | 0066-782X |
| DOI | 10.36660/abc.20230623 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Zs.A 548: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.