Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Reducing perioperative cardiac morbidity and mortality: is this the right goal?

Gordon, Emily K.; Fleisher, Lee A.

Current Opinion in Critical Care: August 2013 - Volume 19 - Issue 4 - p 342–345
doi: 10.1097/MCC.0b013e3283632f33
POSTOPERATIVE PROBLEMS: Edited by Mark Hamilton
Buy

Purpose of review One million people die annually following noncardiac surgery and 4% of patients suffer an adverse cardiac event after surgery. As the number of people having surgery grows, our ability to risk stratify patients becomes more important, particularly in the setting of perioperative myocardial ischemia/necrosis.

Recent findings In recent publications, an increased troponin following noncardiac surgery has been associated with a higher morbidity/mortality in the perioperative setting. The level of troponin elevation associated with increased morbidity/mortality is now believed to be far lower than was previously considered to be pathologic.

Summary The presence of troponin elevations following noncardiac surgery, particularly in at-risk patients, may enable practitioners to better identify high-risk patients in the postoperative setting. After recognizing those patients at increased risk for poor outcomes, practitioners can then make interventions, which may decrease the patients’ in-hospital, 30-day and potentially long-term mortality.

Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, USA

Correspondence to Lee A. Fleisher, MD, Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce Street, Dulles 680, Philadelphia, PA 19104, USA. Tel: +1 215 662 3738; fax: +1 215 349 5341; e-mail: lee.fleisher@uphs.upenn.edu

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins