Myocardial Injury After Noncardiac Surgery and its Association With Short-Term Mortality
Myocardial Injury After Noncardiac Surgery and its Association With Short-Term Mortality
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DOI：
10.1161/circulationaha.113.002128
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发表时间：
2013-06-11
期刊：
影响因子：
37.8
通讯作者：
van Klei, Wilton A.
中科院分区：
文献类型：
--
作者：
van Waes, Judith A. R.;Nathoe, Hendrik M.;van Klei, Wilton A.
背景-为了识别术后心肌损伤和死亡的风险，建议在非心脏手术后常规测量心肌肌钙蛋白。我们医院也进行了这样的监测。本研究的目的是确定术后心肌损伤的预测价值，测量肌钙蛋白升高，对30天死亡率after noncardiac surgery.Methods and Results-这项观察性单中心队列研究包括2232名连续的中高危非心脏手术患者，年龄≥ 60岁，在2011年接受手术。在术后前3天测量肌钙蛋白。对数二项回归分析用于评估术后心肌损伤（肌钙蛋白I水平>0.06 μ g/L）与30天全因死亡率之间的关系。在1627名测量肌钙蛋白I的患者中，315名（19%）发现心肌损伤。全因死亡56例（3%）。肌钙蛋白轻微升高（0.07-0.59 μ g/L）的相对风险为2.4（95%置信区间，1.3-4.2; P= 0.60 μ g/L），为4.2（95%置信区间，2.1-8.6; P
Background- To identify patients at risk for postoperative myocardial injury and death, measuring cardiac troponin routinely after noncardiac surgery has been suggested. Such monitoring was implemented in our hospital. The aim of this study was to determine the predictive value of postoperative myocardial injury, as measured by troponin elevation, on 30-day mortality after noncardiac surgery.Methods and Results- This observational, single-center cohort study included 2232 consecutive intermediate- to high-risk noncardiac surgery patients aged >= 60 years who underwent surgery in 2011. Troponin was measured on the first 3 postoperative days. Log binomial regression analysis was used to estimate the association between postoperative myocardial injury (troponin I level >0.06 mu g/L) and all-cause 30-day mortality. Myocardial injury was found in 315 of 1627 patients in whom troponin I was measured (19%). All-cause death occurred in 56 patients (3%). The relative risk of a minor increase in troponin (0.07-0.59 mu g/L) was 2.4 (95% confidence interval, 1.3-4.2; P= 0.60 mu g/L) was 4.2 (95% confidence interval, 2.1-8.6; P