Abstract
Perioperative myocardial injury is an important reason of mortality and morbidity after neurosurgery. It usually is missed due to its asymptomatic character. In the present study, we investigated myocardial injury after noncardiac surgery (MINS) incidence, the risk factor for MINS, and association of MINS with 30-day mortality in neurosurgery patients. Patients with cardiac risk who underwent elective neurosurgery were enrolled to present prospective cohort study. The patients' demographics, comorbidities, medications used, medical history, and type of operation were recorded. The high-sensitivity cardiac troponin (hs-cTn) levels of the patients were measured 12, 24, and 48h after surgery. The patients were considered MINS-positive if at least one of their postoperative hs-cTn measurement values was ≥ 14ng/l. All the patients were followed up for 30days after surgery for evaluation of their outcomes, including total mortality, mortality due to cardiovascular cause, and major cardiac events. A total of 312 patients completed the study and 64 (20.5%) of them was MINS-positive. Long antiplatelet or anticoagulant drug cessation time (OR: 4.9, 95% CI: 2.1-9.4) was found the most prominent risk factor for MINS occurrence. The total mortality rate was 2.4% and 6.2% in patients MINS-negative and MINS-positive, respectively (p = 0.112). The mortality rate due to cardiovascular reasons (0.8% for without MINS, 4.7 for with MINS, and p = 0.026) and incidence of the major cardiac events (4% for without MINS, 10.9 for with MINS, and p = 0.026) were significantly higher in patients with MINS. MINS is a common problem after neurosurgery, and high postoperative hs-cTn level is associated with mortality and morbidity.
Highlights
Previous studies showed that the mortality rate of patients undergoing noncardiac surgery was notable and cardiovascular complications are one of the leading causes of postoperative mortality [6, 16, 21, 24]
The mortality rate due to cardiovascular reasons (0.8% for without myocardial injury after noncardiac surgery (MINS), 4.7for with MINS, and p=0.026) and incidence of the major cardiac event (4% for without MINS, 10.9 for with MINS, and p=0.026) were significantly higher in patients with MINS
MINS is a common problem after neurosurgery and, high postoperative high-sensitivity cardiac troponin (hs-cTn) level is associated with mortality and morbidity
Summary
Previous studies showed that the mortality rate of patients undergoing noncardiac surgery was notable and cardiovascular complications are one of the leading causes of postoperative mortality [6, 16, 21, 24]. MINS includes all perioperative myocardial injuries with or without myocardial infarction (MI), and previous large studies have shown that MINS is an independent predictor of short-term mortality after noncardiac surgery [3, 10, 14, 22, 24]. Neurosurgical patients require special attention as compared with patients undergoing other surgeries in terms of preventing MINS and postoperative mortality. Studies that focused on the incidence and risk factors of MINS and cardiac mortality after neurosurgery are lacking. We investigated myocardial injury after noncardiac surgery (MINS) incidence, the risk factor for MINS and association of MINS with 30-day mortality in neurosurgery patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
