Association Between Postoperative Troponin Levels and 90 Days Mortality Among Patients Undergoing Non-Cardiac Surgery

Madiha Haroon; Areeba Abdullah; Faisal Siddiqi; Mirza Arshad  Beg; Anum Arshad  Beg

doi:10.36283/PJMD13-3/019

Authors

Madiha Haroon Liaquat National Hospital
Areeba Abdullah Liaquat National Hospital and Medical College https://orcid.org/0000-0002-0937-2076
Faisal Siddiqi Liaquat National Hospital and Medical College
Mirza Arshad Beg Liaquat National Hospital and Medical College
Anum arshad beg Dow University of Health Sciences, Karachi

DOI:

https://doi.org/10.36283/PJMD13-3/019

Abstract

Background: Globally, the mortality of non-cardiac surgery patients within the first month is increasing. Monitoring troponin-I levels aids in early mortality risk identification. Hence, the objective of this study was to determine the association between increased postoperative troponin-I levels to 90-day mortality in non-cardiac surgery patients.

Methods: This prospective longitudinal study was conducted at Liaquat National Hospital’s general surgery department from June to December 2018. A total of 188 patients aged 40-70 years receiving a general or regional anesthetic, and undergoing emergency/elective surgery with a ≥2 days hospital stays, a procedure time of ≥2 hours, or blood loss of more than 300ml were recruited using a non-probability consecutive sampling technique. Troponin-I levels were assessed 6 to 12 hours post-surgery, followed by a 90-day phone-based mortality check. Data was analyzed using SPSS v.22. The chi-square test and Fisher’s exact test were applied with a p-value <0.05 considered significant.

Results: Among 188 patients, 11 (5.9%) had positive troponin-I levels, and 23(12.2%) had raised levels in the immediate postoperative period. In 90-day follow-up, 8(4.2%) patients expired, all within the first 5 days, with a significant association between mortality and surgery type (p=0.001). Post-operative troponin-I levels showed a strong association with mortality (p<0.001). The proportion of patients with raised or positive troponin I levels was significantly higher in emergency cases (p<0.001). No deaths occurred in patients with baseline troponin I levels.

Conclusion: Monitoring postoperative troponin I levels can help physicians intervene promptly, potentially reducing mortality in non-cardiac surgery patients.

Keywords: Troponin I, Mortality, Non-cardiac Surgery.

Author Biographies

Madiha Haroon, Liaquat National Hospital

General Surgery Department
Areeba Abdullah, Liaquat National Hospital and Medical College

MBBS
Faisal Siddiqi, Liaquat National Hospital and Medical College

Head of Department Associate Professor, Department of General Surgery
Mirza Arshad Beg, Liaquat National Hospital and Medical College

General Surgery Department
Anum arshad beg, Dow University of Health Sciences, Karachi

MBBS, MCPS, FCPS, Department of Family Medicine

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