Blood Test Could Help to Predict Mortality Risk Following Surgery

A postoperative high-sensitivity troponin T (hsTnT) of 20 ng/L or higher was associated with increased 30-day mortality risk in patients undergoing noncardiac surgery, according to the results of a recent study.

The association between perioperative hsTnT measurements and 30-day mortality and myocardial injury after noncardiac surgery (MINS) is not well understood.
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To examine this relationship, researchers conducted a prospective cohort study of 21,842 patients aged 45 years or older who underwent noncardiac surgery and had a postoperative hsTnT measurement recorded.

Overall, 266 patients died within 30 days following surgery. Compared with the reference group, peak postoperative hsTnT levels of 20 ng/L to less than 65 ng/L, 65 ng/L to less than 1000 ng/L, and 1000 ng/L or higher were associated with 30-day mortality rates of 3.0%, 9.1%, and 29.6%. An absolute hsTnT change of 5 ng/L or higher and an elevated postoperative hsTnT without an ischemic features (eg, ischemic symptom, ischemic electrocardiography finding) were associated with increased 30-day mortality risk.

Among 3904 patients with MINS, 3633 did not experience ischemic symptoms.

“Among patients undergoing noncardiac surgery, peak postoperative hsTnT during the first 3 days after surgery was significantly associated with 30-day mortality. Elevated postoperative hsTnT without an ischemic feature was also associated with 30-day mortality,” the researchers concluded.

—Michael Potts

Reference:

Writing Committee for the VISION Study Investigators. Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery. JAMA. 2017;317(16):1642-1651.