Elevated cardiac troponin in the early post-operative period and mortality following ruptured abdominal aortic aneurysm: a retrospective population-based cohort study
Critical Care, 08/08/2012
Kopolovic I et al. – Elevated cardiac–specific troponin (cTnI) early after ruptured abdominal aortic aneurysms (rAAA) repair is an independent predictor for post–operative complications and death.Methods
- Retrospective population-based cohort study of all referrals for emergency repair of rAAA in central and northern Alberta, from January 1, 2002 to December 31, 2009.
- Demographic, clinical, physiologic and laboratory data were extracted, along with cardiac-specific investigations and events in the 72hours following rAAA repair.
- In total, 55% of patients (n=77/141) had elevated cTnI, of which 12% (n=9) had ST segment elevation, 23% (n=18) had ST segment depression, 5% (n=4) had other ECG changes, and 61% (n=47) had no diagnostic ECG changes.
- Those with positive cTnI were more likely to have coronary artery disease (45.5% vs. 23.4%, p=0.01) and higher acute physiology and chronic health evaluation II scores (24.9 vs. 21.4, n=0.016).
- cTnI positive patients were more likely to receive vasoactive support (58.4% vs. 14.1%, P<0.001), had longer intensive care unit (ICU) lengths of stay (8 [3-11] vs. 4 [2-9]days, P=0.02) and higher adjusted in-hospital mortality (40.3% vs. 14.1%; OR 4.23; 95% CI, 1.47-12.1; P=0.007).