Postoperative visits by dedicated anesthesiologists in patients with elevated troponin: a retrospective cohort study evaluating postoperative care utility and early detection of complications

Perioperative Medicine
Annemarie AkkermansJudith A R van Waes

Abstract

An elevated cardiac troponin level after noncardiac surgery is associated with both morbidity and mortality. Guidelines suggest routine troponin monitoring in high-risk patients. We implemented a dedicated anesthesia team to conduct follow-up on patients with postoperative troponin elevation. We hypothesized that these visits would facilitate early detection of complications. Therefore, the aim of this study was to evaluate the effect of postoperative visits by dedicated anesthesiologists on early detection of complications and care utility. This retrospective observational study included patients aged ≥ 60 years with an elevated troponin within the first 3 days after noncardiac surgery. Troponin elevation was detected by routine biomarker monitoring. The primary outcome was early detected myocardial infarctions by the dedicated anesthesiologist. Other outcomes were overall detected complications, additional diagnostic tests and treatment advised by the anesthesiologist, consultation of another medical specialist, and advised postoperative follow-up at the outpatient cardiac clinic within 1 week after surgery. Of the 811 patients, 509 (63%) received a postoperative consultation by the anesthesiologist. Anesthesiologists were in...Continue Reading

References

Apr 20, 2011·Annals of Internal Medicine·P J DevereauxUNKNOWN POISE (PeriOperative ISchemic Evaluation) Investigators
Jun 19, 2012·JAMA : the Journal of the American Medical Association·P J DevereauxSalim Yusuf
May 15, 2013·Circulation·Judith A R van WaesUNKNOWN Cardiac Health After Surgery (CHASE) Investigators
Aug 12, 2014·European Heart Journal·Steen D Kristensen, Juhani Knuuti
Dec 17, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Duminda N Wijeysundera
Apr 26, 2016·Anesthesia and Analgesia·Judith A R van WaesUNKNOWN Cardiac Health After Surgery (CHASE) Investigators
Apr 27, 2017·JAMA : the Journal of the American Medical Association·UNKNOWN Writing Committee for the VISION Study InvestigatorsGordon H Guyatt
Mar 14, 2018·Anesthesia and Analgesia·W Scott BeattieUNKNOWN ANZCA Clinical Trials Network for the ENIGMA-II Investigators
May 18, 2018·European Journal of Preventive Cardiology·Annemarie AkkermansWilton A van Klei
Dec 21, 2018·Circulation·Kristian ThygesenUNKNOWN Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American He

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Citations

Oct 22, 2020·International Anesthesiology Clinics·Duminda N Wijeysundera
May 20, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Scott Beattie

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