Troponin I as a Mortality Marker After Lung Resection Surgery – A Prospective Cohort Study

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Troponin I as a Mortality Marker After Lung Resection Surgery – A Prospective Cohort Study

JournalBMC Anesthesiology
Publication date – May – 2020
Authors – Ricardo B Uchoa, Bruno Caramelli
KeywordsAcute coronary syndromes, Cardiovascular complications, Cardiovascular risk, Myocardial infarction, Non-cardiac surgery, Perioperative care, Preoperative, thoracic surgery, Troponin.
Open access – Yes
SpecialityCardiothoracic surgery
World region South America
Country: Brazil
Language – English
Submitted to the One Surgery Index on May 28, 2020 at 7:42 pm
Abstract:

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.

OSI Number – 20413
PMID – 32429842

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