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Association between postoperative haemoglobin and myocardial injury after noncardiac surgery: a retrospective cohort analysis

British Journal of Anaesthesia · Ocak 2021

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YÖKSİS Kayıtları
Association between postoperative haemoglobin and myocardial injury after noncardiac surgery: a retrospective cohort analysis
British Journal of Anaesthesia · 2021 SCI-Expanded
Prof. Dr. İBRAHİM ÖZKAN ÖNAL →
YÖKSİS ISSN Eşleşmesi

Bu dergide (ISSN eşleşmesi) kurumun 8 kaydı bulundu.

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2008 ISSN: 0007-0912 SCI
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Intraoperative transfusion practices in Europe
2016 ISSN: 0007-0912 SCI
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Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications
2019 ISSN: 0007-0912 SCI
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Association between postoperative haemoglobin and myocardial injury after noncardiac surgery: a retrospective cohort analysis
2021 ISSN: 0007-0912 SCI-Expanded Q1
Prof. Dr. İBRAHİM ÖZKAN ÖNAL →
Risk assessment for major adverse cardiovascular events after noncardiac surgery using self-reported functional capacity: international prospective cohort study
2023 ISSN: 0007-0912 SCI-Expanded
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Pathological findings associated with the updated European Society of Cardiology 2022 guidelines for preoperative cardiac testing: an observational cohort modelling study
2024 ISSN: 0007-0912 SCI Q1
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Association between self-reported functional capacity and general postoperative complications: analysis of predefined outcomes of the MET-REPAIR international cohort study
2024 ISSN: 0007-0912 SCI Q1
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Makale Bilgileri

ISSN00070912
Yayın TarihiOcak 2021
Cilt / Sayfa126 · 94-101
Erişim🔓 Açık Erişim
Özet Background: Myocardial injury after noncardiac surgery (MINS) is common, mostly silent, and a strong predictor of postoperative mortality. MINS appears to result from myocardial supply–demand mismatch. Recent data support restrictive perioperative transfusion strategies that can result in low postoperative haemoglobin concentrations. Whether low postoperative haemoglobin is associated with myocardial injury remains unknown. We therefore tested the hypothesis that anaemia is associated with an increased risk of myocardial injury in adults having noncardiac surgery. Methods: We conducted a retrospective analysis of adults ≥45 yr old who had routine postoperative troponin T (TnT) monitoring after noncardiac surgery at the Cleverland Clinic (including those enrolled in the PeriOperative ISchemic Evaluation-2 Trial [POISE-2], the Safety of Addition of Nitrous Oxide to General Anaesthesia in At-risk Patients Having Major Non-cardiac Surgery [ENIGMA-II], Vascular Events In Noncardiac Surgery Patients Cohort Evaluation Study [VISION], and Anaesthetic Depth and Complications After Major Surgery [BALANCED] trial). Patients with baseline increase in TnT and non-ischaemic aetiologies for TnT increase were excluded. The association between postoperative haemoglobin concentration during the 3 initial postoperative days and the incidence of MINS (fourth-generation TnT ≥0.03 ng ml−1 judged as attributable to ischaemia) was assessed using a time-varying covariate Cox proportional hazards survival analysis. Results: Among 6141 patients, 4480 were analysed. The incidence of MINS was 155/4480 (3.5%), ranging from 0/345 (0%) among patients whose lowest postoperative haemoglobin exceeded 13 g dl−1 to 52/611 (8.5%) in patients whose minimum postoperative haemoglobin was <8 g dl−1. The confounder-adjusted hazard ratio [95% confidence interval] for having MINS was 1.29 [1.16–1.42] for every 1 g dl−1 decrease in postoperative haemoglobin in a time-varying covariate analysis. Similar associations were identified in sensitivity analyses. Conclusion: Lower postoperative haemoglobin values are associated with MINS. Whether this association is modifiable by prevention or treatment of anaemia remains to be determined.

Yazarlar (12)

1
Alparslan Turan
2
Barak Cohen
3
Eva Rivas
4
Liu Liu
5
Xuan Pu
6
Kamal Maheshwari
7
Ehab Farag
8
Ozkan Onal
ORCID: 0000-0002-5574-1901
9
Jiayi Wang
10
Kurt Ruetzler
11
Philip J. Devereaux
12
Daniel I. Sessler

Anahtar Kelimeler

anaesthesia cardiovascular risk noncardiac surgery perioperative anaemia postoperative outcomes

Kurumlar

Cleveland Clinic Foundation
Cleveland United States
Hamilton Health Sciences
Hamilton Canada
McMaster University
Hamilton Canada
Tel Aviv University
Tel Aviv-Yafo Israel
Universitat de Barcelona
Barcelona Spain
Scimago Dergi (ISSN Eşleşmesi)
British Journal of Anaesthesia
Q1
SJR Skoru2,687
H-Index232
YayıncıElsevier Ltd
ÜlkeUnited Kingdom
Anesthesiology and Pain Medicine (Q1)
Dergi sayfasına git

Metrikler

51
Atıf
12
Yazar
5
Anahtar Kelime