Javier J Mateos, Elena De la Fuente, Pablo Valero, David Martínez, Francisco De la Gala, Jose M Bellón, Patricia Duque, Patricia Piñeiro, Alberto Calvo, Almudena Reyes, Carlos Simón, Francisco J Hortal, Ignacio Garutti
{"title":"高灵敏度心肌肌钙蛋白监测在胸外科手术中预测严重术后并发症的应用。","authors":"Javier J Mateos, Elena De la Fuente, Pablo Valero, David Martínez, Francisco De la Gala, Jose M Bellón, Patricia Duque, Patricia Piñeiro, Alberto Calvo, Almudena Reyes, Carlos Simón, Francisco J Hortal, Ignacio Garutti","doi":"10.1053/j.jvca.2025.03.023","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the utility of high-sensitivity cardiac troponin (hs-cTn) monitoring in thoracic surgery to predict severe postoperative complications (sPOCs) according to the Clavien-Dindo classification.</p><p><strong>Design: </strong>Retrospective, observational cohort study.</p><p><strong>Setting: </strong>Tertiary-level hospital involving multiple departments.</p><p><strong>Participants: </strong>A total of 220 patients who underwent lung resection surgery between November 2018 and October 2021, with preoperative and postoperative troponin measurements.</p><p><strong>Interventions: </strong>hs-cTnI levels (Abbott Alinity) were measured before surgery and within the first 24 hours postoperatively. Myocardial injury (MI) was defined as hs-cTnI greater than 26.2 ng/L postoperatively. In addition, the impact of a postoperative cTnI elevation greater than 20% or a preoperative value below 1.6 ng/L on the occurrence of sPOCs is analyzed. Postoperative complications were recorded for the first 30 days and classified using the Clavien-Dindo classification.</p><p><strong>Main measurements and results: </strong>Patients with sPOCs had higher pre- and postoperative hs-cTnI levels compared to those without complications. Patients with MI had a higher incidence of POCs than those without MI. Additionally, undetectable preoperative hs-cTnI levels were associated with better survival.</p><p><strong>Conclusions: </strong>Perioperative troponin elevation is associated with worse short-term postoperative outcomes, including a higher incidence of sPOCs and prolonged hospital stays. Preoperative hs-cTnI levels correlate with preoperative morbidity (frailty) in patients.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Utility of High-Sensitivity Cardiac Troponin Monitoring in Thoracic Surgery for Predicting Severe Postoperative Complications.\",\"authors\":\"Javier J Mateos, Elena De la Fuente, Pablo Valero, David Martínez, Francisco De la Gala, Jose M Bellón, Patricia Duque, Patricia Piñeiro, Alberto Calvo, Almudena Reyes, Carlos Simón, Francisco J Hortal, Ignacio Garutti\",\"doi\":\"10.1053/j.jvca.2025.03.023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the utility of high-sensitivity cardiac troponin (hs-cTn) monitoring in thoracic surgery to predict severe postoperative complications (sPOCs) according to the Clavien-Dindo classification.</p><p><strong>Design: </strong>Retrospective, observational cohort study.</p><p><strong>Setting: </strong>Tertiary-level hospital involving multiple departments.</p><p><strong>Participants: </strong>A total of 220 patients who underwent lung resection surgery between November 2018 and October 2021, with preoperative and postoperative troponin measurements.</p><p><strong>Interventions: </strong>hs-cTnI levels (Abbott Alinity) were measured before surgery and within the first 24 hours postoperatively. Myocardial injury (MI) was defined as hs-cTnI greater than 26.2 ng/L postoperatively. In addition, the impact of a postoperative cTnI elevation greater than 20% or a preoperative value below 1.6 ng/L on the occurrence of sPOCs is analyzed. Postoperative complications were recorded for the first 30 days and classified using the Clavien-Dindo classification.</p><p><strong>Main measurements and results: </strong>Patients with sPOCs had higher pre- and postoperative hs-cTnI levels compared to those without complications. Patients with MI had a higher incidence of POCs than those without MI. Additionally, undetectable preoperative hs-cTnI levels were associated with better survival.</p><p><strong>Conclusions: </strong>Perioperative troponin elevation is associated with worse short-term postoperative outcomes, including a higher incidence of sPOCs and prolonged hospital stays. Preoperative hs-cTnI levels correlate with preoperative morbidity (frailty) in patients.</p>\",\"PeriodicalId\":15176,\"journal\":{\"name\":\"Journal of cardiothoracic and vascular anesthesia\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-03-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiothoracic and vascular anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.jvca.2025.03.023\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiothoracic and vascular anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jvca.2025.03.023","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Utility of High-Sensitivity Cardiac Troponin Monitoring in Thoracic Surgery for Predicting Severe Postoperative Complications.
Objectives: To evaluate the utility of high-sensitivity cardiac troponin (hs-cTn) monitoring in thoracic surgery to predict severe postoperative complications (sPOCs) according to the Clavien-Dindo classification.
Participants: A total of 220 patients who underwent lung resection surgery between November 2018 and October 2021, with preoperative and postoperative troponin measurements.
Interventions: hs-cTnI levels (Abbott Alinity) were measured before surgery and within the first 24 hours postoperatively. Myocardial injury (MI) was defined as hs-cTnI greater than 26.2 ng/L postoperatively. In addition, the impact of a postoperative cTnI elevation greater than 20% or a preoperative value below 1.6 ng/L on the occurrence of sPOCs is analyzed. Postoperative complications were recorded for the first 30 days and classified using the Clavien-Dindo classification.
Main measurements and results: Patients with sPOCs had higher pre- and postoperative hs-cTnI levels compared to those without complications. Patients with MI had a higher incidence of POCs than those without MI. Additionally, undetectable preoperative hs-cTnI levels were associated with better survival.
Conclusions: Perioperative troponin elevation is associated with worse short-term postoperative outcomes, including a higher incidence of sPOCs and prolonged hospital stays. Preoperative hs-cTnI levels correlate with preoperative morbidity (frailty) in patients.
期刊介绍：
The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
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