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In inpatients aged 45 years and older, the approximate peri-operative mortality rate after non-cardiac surgery is around 1% to 2%. Half of these deaths are attributed to cardiovascular complications of surgery. Postoperative cardiac troponin elevation with ≥1 measurement of cardiac troponin ≥99% percentile above the upper limit of the reference value, which is an indicator of acute myocardial injury, is seen in the first 30 days after surgery and usually occurs within 72 hours. Myocardial damage is thought to result from an ischemic mechanism. Clinical symptoms may be masked by sedation or analgesia in the perioperative period, so evidence of an ischemic feature (e.g. ischemic symptoms, electrocardiographic changes) is not required. These criteria are defined as MINS (Myocardial Injury Non Cardiac Surgery) criteria. In this study, the investigators aimed to investigate the intensive care follow-up processes and outcomes of geriatric patients over 65 years of age in whom MINS was detected during postoperative intensive care monitoring.
In this study study, 117 geriatric patients aged ≥65 years who were followed and treated in the intensive care unit in the postoperative period after general or regional anesthesia between January 2018 and August 2023 after obtaining Ethics Committee Approval (FSM EAH-KAEK 2023/140) were retrospectively analyzed. Age, gender, comorbidities, coronary artery disease, heart failure, atrial fibrillation, history of chronic renal failure, presence of emergency surgery, preoperative antiaggregant use, ASA score, type of surgery, presence of laparoscopic or open surgery, anesthesia and duration of surgery, intra operatively; hypotension, tachycardia, bradycardia, presence of blood and blood products transfusion, duration if hypotension developed, first day of intensive care unit hospitalization; APACHE, SAPS, SOFA scores, duration of mechanical ventilation, presence and duration of troponin elevation, the day of hospitalization, if cardiac examination was performed; Ejection fraction, diastolic dysfunction, presence of revascularization treatment, hemoglobin, hematocrit levels on the day of troponin elevation, neutrophil/lymphocyte ratio, procalcitonin, crp levels, use of antiaggregants, mechanical thrombophylaxis, acidosis, presence of hypoxia, need for vasopressor therapy, type of discharge from intensive care unit and presence of mortality will be recorded
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Geriatric ICU Patients | Geriatric patients (aged ≥65 years) who underwent surgery under general or regional anesthesia and were admitted to the intensive care unit in the postoperative period between January 2018 and August 2023. |
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| Measure | Description | Time Frame |
|---|---|---|
| 30-day postoperative mortality | Association between postoperative troponin elevation and ICU mortality in geriatric patients. Mortality status recorded in hospital database | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| mechanical ventilation | Duration of mechanical ventilation in patients over 65 years of age with postoperative mins. | 30 days |
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Inclusion Criteria:
Exclusion Criteria:
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This study includes geriatric patients aged 65 years and older who underwent major, moderate, or minor surgery under general and/or regional anesthesia and were followed postoperatively in the intensive care unit between January 2018 and August 2023 at Fatih Sultan Mehmet Training and Research Hospital. The study population consists of patients whose medical records were retrospectively reviewed.
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| Name | Affiliation | Role |
|---|---|---|
| Arzu Yildirim Ar, As Prof | Fatih Sultan Mehmet Training and Research Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fatih Sultan Mehmet Training and Research Hospital, | Istanbul | Atasehir | 34752 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35665266 | Result | Gao L, Chen L, He J, Wang B, Liu C, Wang R, Fan L, Cheng R. Perioperative Myocardial Injury/Infarction After Non-cardiac Surgery in Elderly Patients. Front Cardiovasc Med. 2022 May 19;9:910879. doi: 10.3389/fcvm.2022.910879. eCollection 2022. | |
| 34657407 | Result | Park J, Lee JH. Myocardial injury in noncardiac surgery. Korean J Anesthesiol. 2022 Feb;75(1):4-11. doi: 10.4097/kja.21372. Epub 2021 Oct 18. |
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This is a retrospective observational study. Individual participant data will not be shared.
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| 34601955 | Result | Ruetzler K, Smilowitz NR, Berger JS, Devereaux PJ, Maron BA, Newby LK, de Jesus Perez V, Sessler DI, Wijeysundera DN. Diagnosis and Management of Patients With Myocardial Injury After Noncardiac Surgery: A Scientific Statement From the American Heart Association. Circulation. 2021 Nov 9;144(19):e287-e305. doi: 10.1161/CIR.0000000000001024. Epub 2021 Oct 4. |