HIGH-SENSITIVITY TROPONIN T PREDICTS PERIOPERATIVE ADVERSE EVENTS IN PATIENTS UNDERGOING FEMUR INTERLOCKING PROCEDURES
Abstract
Objectives: Previous studies have shown that troponin is a valuable predictor of perioperative complications after non-cardiac surgery. However, the relationship of the preoperative troponin level with perioperative adverse events has not been well described in patients undergoing orthopaedic surgeries . The aim of this study was to evaluate the impact of the preoperative high-sensitivity cardiac troponin T (hs-cTnT) level on the outcome of patients who underwent long bone interlocking procedures.
Methods: The records of 83 patients who were over 18 years of age and underwent elective femur interlocking between January 2019and December 2019 were retrospectively evaluated. Patient medical and demographic data and the results of routine preoperative laboratory tests, including the hs-cTnT level, were collected to assess a potential association between these factors and perioperative adverse events.
Results: Perioperative adverse events occurred in 5 patients. Older patients and those with more comorbid conditions tended to have a higher rate of perioperative adverse events. The preoperative hs-cTnT level was significantly higher in the individuas who experienced a complicated in-hospital course than in those who did not (22.6±6.7 ng/L vs 6.3±3.1 ng/L; p<0.001). Multivariate analysis indicated that age (odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.16-4.35; p<0.01), the presence of diabetes (OR: 3.13; 95% CI: 1.15-6.32; p=0.004), and a preoperative hs-cTnT level of >18.3 ng/L (OR: 4.51, 95% CI: 2.34–7.82; p<0.001) were significant and independent predictors of perioperative adverse events.
Conclusion: The results of this study indicated that a higher preoperative hs-cTnT level was associated with perioperative adverse events in adult patients undergoing elective orthopaedic surgery.
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Visser A, Geboers B, Gouma DJ, Goslings JC, Ubbink DT. Pre- dictors of surgical complications: A systematic review. Surgery 2015;158:58–65. [CrossRef ]
Tetreault L, Ibrahim A, Côté P, Singh A, Fehlings MG. A system- atic review of clinical and surgical predictors of complications following surgery for degenerative cervical myelopathy. J Neurosurg Spine 2016;24:77–99. [CrossRef ]
Rolston JD, Han SJ, Lau CY, Berger MS, Parsa AT. Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011. J Neurosurg 2014;120:736–45.
Solaro RJ, Rarick HM. Troponin and tropomyosin: proteins that switch on and tune in the activity of cardiac myofilaments. Circ Res 1998;83:471–80. [CrossRef ]
Martin AK, Malhotra AK, Sullivan BL, Ramakrishna H. Troponin elevations in patients with chronic cardiovascular disease: An analysis of current evidence and significance. Ann Card Anaesth 2016;19:321–7. [CrossRef ]
Tanındı A, Cemri M. Troponin elevation in conditions other than acute coronary syndromes. Vasc Health Risk Manag 2011;7:597–603. [CrossRef ]
Leal JC, Petrucci O, Godoy MF, Braile DM. Perioperative serum troponin I levels are associated with higher risk for atrial fib- rillation in patients undergoing coronary artery bypass graft surgery. Interact Cardiovasc Thorac Surg 2012;14:22–5. [CrossRef ]
Muehlschlegel JD, Perry TE, Liu KY, Nascimben L, Fox AA, Col- lard CD, et al. Troponin is superior to electrocardiogram and creatinine kinase MB for predicting clinically significant my- ocardial injury after coronary artery bypass grafting. Eur Heart J 2009;30:1574–83. [CrossRef ]
Reed GW, Horr S, Young L, Clevenger J, Malik U, Ellis SG, et al. Associations Between Cardiac Troponin, Mechanism of My- ocardial Injury, and Long-Term Mortality After Noncardiac Vascular Surgery. J Am Heart Assoc 2017;6. pii: e005672.
Kim BS, Kim TH, Oh JH, Kwon CH, Kim SH, Kim HJ, et al. Associa- tion between preoperative high sensitive troponin I levels and cardiovascular events after hip fracture surgery in the elderly. J Geriatr Cardiol 2018;15:215–21.
Borges FK, Furtado MV, Rossini AP, Bertoluci C, Gonzalez VL, Bertoldi EG, et al. Clinical use of ultrasensitive cardiac troponin I assay in intermediate- and high-risk surgery patients. Dis Markers 2013;35:945–53. [CrossRef ]
Vetrugno L, Langiano N, Gisonni R, Rizzardo A, Venchiarutti PE, Divella M, et al. Prediction of early postoperative major cardiac events after elective orthopedic surgery: the role of B-type na- triuretic peptide, the revised cardiac risk index, and ASA class. BMC Anesthesiol 2014;14:20. [CrossRef ]
Choi JH, Cho DK, Song YB, Hahn JY, Choi S, Gwon HC, et al. Preoperative NT-proBNP and CRP predict perioperative major cardiovascular events in non-cardiac surgery. Heart 2010;96:56–62. [CrossRef ]
Acarbas, High-sensitivity troponin T in neurosurgery / doi: 10.14744/ijmb.2019.02411
Apple FS, Collinson PO. Ifcc Task Force on Clinical Applications of Cardiac Biomarkers. Analytical characteristics of high-sensitivity cardiac troponin assays. Clin Chem 2012;58:54–61. [CrossRef ]
Giannitsis E, Kurz K, Hallermayer K, Jarausch J, Jaffe AS, Katus HA. Analytical validation of a high-sensitivity cardiac troponin T assay. Clin Chem 2010;56:254–61. [CrossRef ]
Wong JM, Bader AM, Laws ER, Popp AJ, Gawande AA. Patterns in neurosurgical adverse events and proposed strategies for reduction. Neurosurg Focus 2012;33:E1. [CrossRef ]
Gillmann HJ, Meinders A, Grohennig A, Larmann J, Bünte C, Calmer S, et al. Perioperative levels and changes of high-sen- sitivity troponin T are associated with cardiovascular events in vascular surgery patients. Crit Care Med 2014;42:1498– 506. [CrossRef]
Park J, Lee SH, Han S, Jee HS, Lee SK, Choi GS, et al. Preop- erative cardiac troponin level is associated with all-cause mortality of liver transplantation recipients. PLoS One 2017;12:e0177838. [CrossRef]
Katsanos S, Mavrogenis AF, Kafkas N, Sardu C, Kamperidis V, Katsanou P, et al. Cardiac Biomarkers Predict 1-Year Mortality in Elderly Patients Undergoing Hip Fracture Surgery. Orthope- dics 2017;40:e417–e24. [CrossRef ]
Ruggieri F, Gemma M, Calvi MR, Nicelli E, Agarossi A, Beretta L. Perioperative serum brain natriuretic peptide and car- diac troponin in elective intracranial surgery. Neurocrit Care 2012;17:395–400. [CrossRef ]
McClendon J Jr, Smith TR, Thompson SE, Sugrue PA, Sauer AJ, O'Shaughnessy BA, et al. Renin-angiotensin system inhibitors and troponin elevation in spinal surgery. J Clin Neurosci 2014;21:1133–40. [CrossRef ]
Macfarlane AI, Rudd D, Knight E, Marshman LA, Guazzo EP, Anderson DS. Prospective controlled cohort study of Troponin I levels in patients undergoing elective spine surgery for de- generative conditions: Prone versus supine position. J Clin Neurosci 2017;35:62–6. [CrossRef ]
Freund Y, Chenevier-Gobeaux C, Bonnet P, Claessens YE, Allo JC, Doumenc B, et al. High-sensitivity versus conventional troponin in the emergency department for the diagnosis of acute myocardial infarction. Crit Care 2011;15:R147. [CrossRef ]
Bohula May EA, Bonaca MP, Jarolim P, Antman EM, Braunwald E, Giugliano RP, et al. Prognostic performance of a high-sensi- tivity cardiac troponin I assay in patients with non-ST-eleva- tion acute coronary syndrome. Clin Chem 2014;60:158–64.
Bonaca MP, O'Malley RG, Murphy SA, Jarolim P, Conrad MJ, Braunwald E, et al. Prognostic performance of a high-sensi- tivity assay for cardiac troponin I after non-ST elevation acute coronary syndrome: Analysis from MERLIN-TIMI 36. Eur Heart J Acute Cardiovasc Care 2015;4:431–40. [CrossRef ]
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