Charlotte Kanstrup (Hillerød / DK), Camilla Mattesen Serup (Hillerød / DK), Kristina Svarre (Hillerød / DK), Jakob Kleif (Hillerød / DK), Lars Hyldborg Lundstrøm (Hillerød / DK), Rolf Steffensen (Hillerød / DK), Claus Anders Bertelsen (Hillerød / DK)
Abstract text (incl. references and figure legends)
Introduction
Patients undergoing acute high-risk abdominal (AHA) surgery are at risk of developing myocardial injury after non-cardiac surgery (MINS). MINS is a prognostic relevant myocardial tissue injury and an independent predictor of 30-day mortality1. MINS is diagnosed by an elevated plasma troponin (TnI). We aim to determine the incidence and mortality of MINS among AHA-patients.
Material & Methods
Patients aged 50 and over undergoing surgery for perforation, obstruction or mesenterial ischemia at Copenhagen University Hospital – North Zealand from March 2019 to February 2021 were included. Plasma-TnI was measured preoperatively, 6-12 hours and on day 1–4 postoperatively. Patients with TnI >59 were diagnosed with MINS and assessed individually to decide further treatment and level of care. Data on vital status was collected from the Civil Registration System. The cumulative incidences were calculated using competing risk analysis and all-cause mortality analysed using logistic regression.
Results
A total of 355 patients were included. Postoperative TnI was measured in 314 patients, 81 patients (25,8%) developed MINS. Patients with MINS were generally older (71.875 vs 781, p<0.001) and had a higher ASA-score (<0.001). The absolute unadjusted risk of all-cause mortality was 21.0% [CI: 121–29.9%] for patients with MINS versus 3.0% [CI: 0.8–5.2] for patients without. Adjusted by Inverse Probability Weighting for ASA, age, BMI, cardiovascular diseases, type of procedure, resection of organ, and diagnosis, the 30-day mean risk of death was 24.1% [CI: 126–35,5%] for patients with MINS and 4.0% [CI: 1.5–6.5] for patients without MINS, p=0.0008.
Conclusions
MINS is significantly associated with 30-day mortality.
References
1. Botto et al. Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30-day outcomes. Anesthesiology 2014;120:564–780
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The authors declare no conflict of interest.