Key result
Elevation of troponin I on the first postoperative day after lung resection surgery was associated with a 12-fold increase in mortality risk within one year (HR 12.02).
Why the study?
Elevated cardiac troponin predicts complications after non-cardiac surgeries, but its role after thoracic surgeries remains undetermined.
Does postoperative troponin I elevation predict mortality within one year in patients undergoing elective lung resection surgery?
Cohort (n=151)
No
Does postoperative troponin I elevation predict mortality within one year in patients undergoing elective lung resection surgery?
Hazard Ratio: 12.02 (95% CI 1.82–79.5)
p-value: p=0.01
In patients undergoing elective lung resection surgery, postoperative troponin I elevation is a strong independent predictor of one-year mortality, even among those considered to have low cardiovascular risk.
May flag high-risk lung resection patients for surveillance; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Cardiovascular complications associated with thoracic surgery increase morbidity, mortality, and treatment costs. Elevated cardiac troponin level represents a predictor of complications after non-cardiac surgeries, but its role after thoracic surgeries remains undetermined. The objective of this study was to analyze the relationship between troponin I elevation and morbidity and mortality after one year in patients undergoing lung resection surgery. METHODS: This prospective cohort study evaluated 151 consecutive patients subjected to elective lung resection procedures using conventional and video-assisted thoracoscopic techniques at a University Hospital in Brazil, from July 2012 to November 2015. Preoperative risk stratification was performed using the scores obtained by the American College of Physicians (ACP) and the Society of Cardiology of the state of São Paulo (EMAPO) scoring systems. Troponin I levels were measured in the immediate postoperative period (POi) and on the first and second postoperative days. RESULTS: Most patients had a low risk for complications according to the ACP (96.7%) and EMAPO (82.8%) scores. Approximately 49% of the patients exhibited increased troponin I (≥0.16 ng/ml), at least once, and 22 (14.6%) died in one year. Multivariate analysis showed that the elevation of troponin I, on the first postoperative day, correlated with a 12-fold increase in mortality risk within one year (HR 12.02, 95% CI: 1.82-79.5; p = 0.01). CONCLUSIONS: In patients undergoing lung resection surgery, with a low risk of complications according to the preoperative evaluation scores, an increase in troponin I levels above 0.16 ng/ml in the first postoperative period correlated with an increase in mortality within one year.
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Uchoa et al. (2020) conducted a cohort in Lung resection surgery (n=151). Postoperative troponin I elevation (≥0.16 ng/ml) vs. Normal troponin I levels (<0.16 ng/ml) was evaluated on Mortality within one year (HR 12.02, 95% CI 1.82-79.5, p=0.01). Elevation of troponin I on the first postoperative day after lung resection surgery was associated with a 12-fold increase in mortality risk within one year (HR 12.02).
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