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Troponin orthopaedic

A Duma, C Wagner, M Titz, M Maleczek, M Hüpfl, V B Weihs, E Samaha, H Herkner, T Szekeres, M Mittlboeck, M G Scott, A S Jaffe, P Nagele
BACKGROUND: It is unclear if isolated postoperative cardiac-troponin elevation, often referred to as myocardial injury, represents a pathological event, as control studies in otherwise healthy adults are lacking. METHODS: In this single-centre prospective observational cohort study, serial high-sensitivity cardiac troponin T (hscTnT) plasma concentrations were obtained from young, healthy adults undergoing elective orthopaedic surgery at three time points: before operation, 2-6 h, and 18-30 h after surgery...
February 2018: British Journal of Anaesthesia
Krzysztof Jankowski, Janusz Trzebicki, Maksymilian Bielecki, Beata Łągiewska, Katarzyna Kurnicka, Magdalena Koczaj-Bremer, Marek Pacholczyk, Piotr Pruszczyk
An elevation in plasma cardiac troponins is an indicator of increased perioperative risk in orthopaedic and vascular surgery, however, data on liver transplantation (LTx) are scarce. The aim of the study was to evaluate the prevalence of cardiac troponin I (cTnI) elevation in the perioperative period of LTx, and its potential relationship with 1-year mortality. MATERIAL AND METHODS: Analysis included 79 patients with liver cirrhosis. During LTx all patients underwent hemodynamic measurements...
2017: Acta Biochimica Polonica
Alexander Fisher, Wichat Srikusalanukul, Leon Fisher, Paul Smith
AIM: To investigate the association of the neutrophil to lymphocyte ratio (NLR) at admission with presence of fracture, comorbid conditions, and its prognostic value for short-term outcomes in orthogeriatric patients. METHODS: On 415 consecutive patients (mean age 78.8 ±8.7[SD] years, 281 women, 255 with a non-vertebral bone fracture, including 167 with a hip fracture, HF) admitted to the Department of Orthopaedic Surgery at the Canberra hospital (2010 - 2011) data on clinical and laboratory characteristics were collected prospectively...
2016: International Journal of Medical Sciences
Carlo Rostagno, Alessandra Cammilli, Annalaura Di Cristo, Gian Luca Polidori, Claudia Ranalli, Alessandro Cartei, Roberto Buzzi, Domenico Prisco
Myocardial infarction after hip fracture but before surgical repair is associated with a 30-day mortality as high as 30 % at 1 month. In Florence, since 2011, hip fractures are referred to a multidisciplinary hip fracture team including internal medicine specialists, anesthesiologists, and orthopaedic surgeons. The aim of the present investigation was to evaluate the clinical characteristics of patients with hip fracture who had at hospital admission a significant increase of troponin (>10 times reference levels), the diagnostic and therapeutic strategies adopted, and overall 1-year survival...
March 2016: Internal and Emergency Medicine
Carol P Chong, William J van Gaal, Konstantinos Profitis, Julie E Ryan, Judy Savige, Wen Kwang Lim
INTRODUCTION: The relationship between electrocardiograph (ECG) changes and troponin levels after the emergency orthopaedic surgery are not well characterised. The aim of this study was to determine the correlation between ECG changes (ischaemia or arrhythmia), troponin elevations perioperatively and cardiac complications. MATERIALS AND METHODS: One hundred and eighty-seven orthopaedic patients over 60 years of age were prospectively tested for troponin I and ECGs were performed on the fi rst 3 postoperative mornings or until discharge...
January 2013: Annals of the Academy of Medicine, Singapore
Richard F Alcock, Dorothy Kouzios, Christopher Naoum, Graham S Hillis, David B Brieger
OBJECTIVE: Cardiovascular complications are important causes of morbidity and mortality in elective non-cardiac surgery. Although difficult to diagnose, perioperative myocardial infarction (MI) remains prognostically important. High-sensitivity troponin T (hs-TnT) assays allow detection of very minor damage to cardiac muscle. These assays are yet to be fully evaluated in the perioperative setting. Our aim was to determine the incidence and predictors of myocardial necrosis in patients at high cardiovascular risk undergoing elective non-cardiac surgery using hs-TnT...
May 2012: Heart: Official Journal of the British Cardiac Society
Carol P Chong, William J van Gaal, Julie E Ryan, Konstantinos Profitis, Judy Savige, Wen Kwang Lim
OBJECTIVES: Troponin elevations are common after emergency orthopaedic surgery and confer a higher mortality at one year. The objective was to determine if comprehensive cardiology care after emergency orthopaedic surgery reduces mortality at one year in patients who sustain a post-operative troponin elevation versus standard care. METHODS: A randomised controlled trial was conducted at a metropolitan teaching hospital in Melbourne, Australia. 187 consecutive patients were eligible with 70 patients randomised...
July 2012: Injury
Carol P Chong, William J van Gaal, Judy Savige, Wen Kwang Lim
BACKGROUND: Cardiac injury after orthopaedic surgery is an increasing problem particularly in an ageing population. The detection of cardiac injury has been aided by the use of cardiac troponins which has also raised questions about the utility of this enzyme in the post-operative setting. OBJECTIVE: This review evaluates the diagnosis and pathophysiology of myocardial infarction after orthopaedic surgery and examines how myocardial injury is detected, with particular emphasis on the role of troponin testing...
September 2011: Injury
Giuseppe Lippi, Gianfranco Cervellin, Mario Plebani
No abstract text is available yet for this article.
March 2011: International Orthopaedics
C Chong, Q Lam, J Ryan, R Sinnappu, W K Lim
OBJECTIVES: To determine the association between post-operative troponin rises and longer term (2-year) mortality after emergency orthopaedic surgery in patients over 60 years of age. METHODS: One hundred and two patients were recruited in 2006 and had inpatient troponin 1 measurements. These patients were followed up by a telephone call annually for complications. RESULTS: At 2 years, 29.4% (30/102) of patients had died. Twenty-five patients (25/54 or 49...
November 2010: Internal Medicine Journal
Russell G Cohen, Jay A Katz, Nebojsa V Skrepnik
Various reports confirm elevations in serum markers associated with skeletal muscle injury after orthopaedic surgery in the absence of overt clinical manifestations of myocardial injury. We therefore measured the influence surgical approach has on these serum markers after primary THA. We nonrandomly enrolled 30 nonconsecutive patients undergoing THA in three groups of 10 based on current surgical approaches used at our facility: (1) minimally invasive (MIS) modified Watson Jones approach; (2) miniposterior transmuscular approach (MIS-I); and (3) MIS-II incision...
July 2009: Clinical Orthopaedics and related Research
Carol P Chong, Que T Lam, Julie E Ryan, Rabindra N Sinnappu, Wen Kwang Lim
OBJECTIVES: to determine the incidence of post-operative troponin I rises and its association with 1-year all-cause mortality and cardiac events after emergency orthopaedic-geriatric surgery, which has not been studied before. METHODS: one hundred and two patients over the age of 60 were recruited and followed up at 1 year. All consented to serial troponin I measurements peri-operatively. RESULTS: the incidence of a troponin I rise post-operatively was 52...
March 2009: Age and Ageing
G Godet, Y Le Manach, F Lesache, S Perbet, P Coriat
BACKGROUND: Recent publications have reported high incidence of perioperative complications in patients with drug-eluting stent (DES). The recommendations for bare-metal stents (BMS) are not applicable to DES. In fact, large evidence-based studies are lacking on which to base a consensus for the perioperative management of patients with DES. The aim of the present study is to evaluate the postoperative cardiac risk associated with DES. METHODS: Prospectively collected data were examined for the rate of postoperative cardiac complications in 96 consecutive patients with DES who underwent digestive, urologic, orthopaedic, or vascular surgery...
April 2008: British Journal of Anaesthesia
C Olofsson, E B Nygårds, S Ponzer, B Fagrell, R Przybelski, P E Keipert, N Winslow, R M Winslow
The objective of this study was to further explore the safety of Hemospan (Sangart Inc., San Diego, CA, USA), an oxygen-carrying plasma expander. The aim of this study was to determine if Hemospan is well tolerated in orthopaedic surgery patients with spinal anaesthesia in doses up to 1 L. Hemospan was previously found to be well tolerated in normal volunteers and orthopaedic surgery patients with spinal anaesthesia in doses up to 500 mL. Five cohorts of six orthopaedic surgery patients, American Society of Anesthesiologists (ASA) I and II, were studied...
February 2008: Transfusion Medicine
Pietro Amedeo Modesti, Ignazio Simonetti, Giuseppe Olivo
Advances in surgical and anaesthetic techniques and an aging patient population have resulted in more complex procedures being performed in greater numbers of aged subjects and in patients with a high likelihood of significant cardiovascular disease. Nearly one fourth of non-cardiac surgical procedures (major intra-abdominal, thoracic, vascular, and orthopaedic procedures) performed in persons older than 65 years have been found to be associated with significant perioperative cardiovascular morbidity and mortality...
2006: Internal and Emergency Medicine
W D Neary, A McCrirrick, C Foy, B P Heather, J J Earnshaw
BACKGROUND: Perioperative beta blockade has been shown to reduce mortality after major elective surgery. The aim of this study was to determine whether it could reduce the rate of death and morbidity from cardiac complications in high risk patients undergoing emergency surgery. METHODS: Over a one-year interval all patients undergoing major non-elective orthopaedic or general surgery were screened to identify those at high risk of cardiac complications. Consenting, high risk patients were randomly allocated atenolol or placebo for seven days, commencing at anaesthetic induction...
June 2006: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
F Neill, J W Sear, G French, H Lam, M Kemp, R J Hooper, P Foex
We investigated the use of measurements of serum concentrations of the cardiac proteins troponins I and T as biochemical markers of myocardial cell damage in 80 patients undergoing vascular or major orthopaedic surgery. Holter electrocardiographic monitoring was carried out before surgery and for 3 days after surgery. Blood samples for troponins I and T and creatine kinase-MB isoenzyme were taken on each of these 4 days. Outcome was assessed at 3 months using a patient questionnaire, general practitioner follow-up and case notes review...
July 2000: Anaesthesia
H A Katus, M Schoeppenthau, A Tanzeem, H G Bauer, W Saggau, K W Diederich, S Hagl, W Kuebler
Troponin T is a unique cardiac antigen which is continuously released from infarcting myocardium. Its cardiospecificity as a marker protein might be particularly useful in assessing myocardial cell damage in patients undergoing cardiac surgery. Therefore, circulating troponin T was measured in serial blood samples from 56 patients undergoing cardiac surgery and in two control groups--22 patients undergoing minor orthopaedic surgery and 12 patients undergoing lung surgery by median sternotomy. In both control groups no troponin T could be detected, whereas activities of creatine kinase were raised in all 12 lung surgery controls and activities of the MB isoenzyme were raised in five of the 12 patients in the lung surgery group and in four of the 22 patients in the orthopaedic surgery group, respectively...
May 1991: British Heart Journal
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