Addition of High-Sensitivity Troponin to Perioperative Risk Assessment Improves the Predictive Ability of Death in Non-Cardiac Surgery Patients

Risk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables. Evaluate the incremental power of troponin to the usual risk stratification. A total of 2,230 patients admitted to the intensive care unit afte...

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Published in:Arquivos brasileiros de cardiologia 2024-04, Vol.121 (4), p.e20230623-e20230623
Main Authors: Gomes, Bruno Ferraz de Oliveira, Silva, Thiago Moreira Bastos da, Dutra, Giovanni Possamai, Peres, Leticia de Sousa, Camisão, Nathalia Duarte, Homena Júnior, Walter de Souza, Petriz, João Luiz Fernandes, Carmo Junior, Plinio Resende do, Pereira, Basilio de Bragança, Oliveira, Gláucia Maria Moraes de
Format: Article
Language:eng ; por
Subjects:
Aged
Biomarkers - blood
Cardiovascular Diseases - blood
Cardiovascular Diseases - mortality
Female
Humans
Male
Middle Aged
Perioperative Period
Postoperative Complications - blood
Postoperative Complications - mortality
Predictive Value of Tests
Risk Assessment - methods
Risk Factors
Surgical Procedures, Operative - adverse effects
Surgical Procedures, Operative - mortality
Time Factors
Troponin - blood
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Summary:Risk stratification is an important step in perioperative evaluation. However, the main risk scores do not incorporate biomarkers in their set of variables. Evaluate the incremental power of troponin to the usual risk stratification. 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. 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
ISSN:1678-4170
DOI:10.36660/abc.20230623