One-Year Mortality, Causes of Death, and Cardiac Interventions in Patients with Postoperative Myocardial Injury
Key result
Postoperative myocardial injury was associated with an increased risk of 1-year all-cause mortality (RR 1.4 for minor to 2.2 for major elevation, P≤0.004), but not cardiac mortality.
Why the study?
Is postoperative myocardial injury associated with increased 1-year mortality in patients ≥60 years old undergoing major noncardiac surgery?
Population
3,224 patients ≥60 years old undergoing major noncardiac surgery at a tertiary care center
Comparison
Postoperative myocardial injury vs Patients without postoperative myocardial injury
Design
Cohort, unblinded
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
May prompt enhanced postoperative monitoring in elderly noncardiac surgery patients; leaves open whether cardiac interventions improve survival.
Study Design
Type
Cohort (n=3,224)
Blinding
Unblinded
Multicenter
No
Structured PICO
Is postoperative myocardial injury associated with increased 1-year mortality in patients ≥60 years old undergoing major noncardiac surgery?
P
Population
3,224 patients aged ≥60 years undergoing major noncardiac surgery, evaluated for 1-year mortality following routine postoperative troponin surveillance.
E
Exposure
Postoperative myocardial injury (defined as troponin I >0.06 μg/L measured routinely on the first 3 postoperative days)
C
Comparator
Patients without postoperative myocardial injury
O
Outcome
1-year all-cause mortalityhard clinical
Main Result
Relative Risk: 1.4
p-value: p=0.004
Postoperative myocardial injury after major noncardiac surgery is associated with a dose-dependent increase in 1-year all-cause mortality, though cardiac interventions are initiated in a minority of these patients.
Cite This Study
Waes et al. (2016) conducted a cohort in Major noncardiac surgery (n=3,224). Postoperative myocardial injury vs. No myocardial injury was evaluated on 1-year all-cause mortality (RR 1.4, p=0.004). Postoperative myocardial injury was associated with an increased risk of 1-year all-cause mortality (RR 1.4 for minor to 2.2 for major elevation, P≤0.004), but not cardiac mortality.