Myocardial injury in elderly patients after abdominal surgery

Huang, Shun; Peng, Wenping; Yang, Ning; Yu, Tao; Cui, Hong; Xu, Jing; An, Q.; Yang, Hua; Liu, Yan Nan; Li, Zhe; Zuo, Ming Zhang

doi:10.1007/s40520-018-0908-y

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…In patients with sepsis, the inflammatory response mediates myocardial inhibition, overactivation of nervoushumoral regulation, and changes in molecular and gene regulation, contributing to inhibition of myocardial function. 6,7 Not only pulmonary hypertension, but also right heart failure due to overload of ventricular pressure caused by pulmonary hypertension, were found in the Staphylococcus aureus pneumonia rat model. 16 Cardoso et al 17 reported that the mortality rate in patients with infection and cardiac insufficiency was higher than that in patients with infection alone (21.5% vs 17.6%, P < 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion criteria were as follows: (1) diagnosis of sepsis according to the sepsis-3 definition 2 on admission to the ICU; (2) cardiac troponin I (cTnI) levels >0.04 ng/mL (detected by the PATHFAST chemiluminescence immunoassay; Beijing Friendship Hospital, Capital Medical University, Beijing, China) on admission to the ICU; 6 and (3) age ≥18 years. The exclusion criteria were as follows: patients with a history of myocardial disease, valvular heart disease, congenital heart, acute coronary syndrome, severe heart failure, cardiothoracic surgery, chest compression, defibrillation, direct current cardioversion, tumor, or autoimmune disease; and pregnant women.…”

Section: Methodsmentioning

confidence: 99%

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Risk factors for 28-day mortality in patients with sepsis-related myocardial injury in intensive care units

et al. 2021

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Objective This study aimed to identify the risk factors for death in patients with sepsis-related myocardial injury. Methods A retrospective study was conducted in 158 patients with sepsis-related myocardial injury in a mixed medical intensive care unit from January 2009 to March 2020. The patients were divided into those who survived and those who died on the basis of whether they survived after 28 days. Demographic and clinical parameters were collected. Multivariate logistic regression was performed. Results Sixty-nine (43.7%) patients died within 28 days after admission to the intensive care unit. Multivariate logistic regression analysis showed that the oxygenation index (odds ratio [OR]: 0.979, 95% confidence interval [CI]: 0.970–0.989), acute kidney injury (OR: 4.787, 95% CI: 1.674–13.693), norepinephrine dose (OR: 1.706, 95% CI: 1.375–2.117), and abdominopelvic cavity infection (OR: 0.257, 95% CI: 0.076–0.866) were significantly associated with mortality within 28 days after admission in patients with sepsis-related myocardial injury. Conclusions Patients with sepsis-related myocardial injury have a high mortality rate. A high oxygenation index, occurrence of acute kidney injury, high norepinephrine dose, and occurrence of abdominopelvic cavity infection are independent risk factors for 28-day mortality in patients with sepsis-related myocardial injury.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Risk factors for 28-day mortality in patients with sepsis-related myocardial injury in intensive care units

et al. 2021

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“…Elevated levels of hs-cTnI is associated with higher mortality in non-cardiac hospitalized patients [ 4 – 6 ], including patients with gastrointestinal tumors [ 7 ]. Taken together, myocardial injury should be given high priority [ 8 ]. Considering the shared cardiovascular risks between tumors and cardiovascular disease [ 9 ], inflammatory states associated with malignancies, and cardiotoxic effects of cancer therapy, gastrointestinal tumors complicated with myocardial injury may be common.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of preoperative myocardial injury in patients with gastrointestinal tumors

Shi-ying

Cheng

et al. 2023

BMC Cardiovasc Disord

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Background Recent studies indicated that the prognosis of patients with gastrointestinal tumors is frequently influenced by its complications, notably myocardial injury. The main object is to investigate the occurrence and risk factors of myocardial injury in patients with gastrointestinal tumor. Methods 1126 patients who received gastrointestinal tumor related surgery from May 2018 to June 2020 in the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively collected and divided into the non-myocardial injury group and the myocardial injury group (high-sensitive cardiac troponin I (hs-cTnI) ≥ 0.028 ng/ml). The occurrence and risk factors of myocardial injury in patients with gastrointestinal tumor are analyzed. The influence of myocardial injury on the ICU detention time in gastrointestinal tumor patients is also studied. Results In total, 78 (6.93%) patients developed myocardial injuries. Compared with patients in the non-myocardial injury group, patients in the myocardial injury group have a higher prevalence of cardiovascular risk factors (including advanced age and higher smoking ratio), a higher prevalence of comorbidities (such as previous coronary artery disease, hypertension, atrium fibrillation and diabetes), and a higher rate of premedication (such as anticoagulation, β-blocker, Angiotensin-converting enzyme inhibitor/Angiotensin II receptor blocker, and diuretic) (all with P-value < 0.05). In addition, patients in the myocardial injury group also presented with a higher revised cardiac risk index (Lee index), higher neutrophil granulocyte ratio, lower hemoglobin, and higher likelihood of impaired cardiac structure and function (all with P-value < 0.05). There was a trend of statistical significance in the ICU detention time between the myocardial injury group and the non-myocardial injury group (1[1,3] vs. 2[1,10], P = 0.064). In this study, there were 7 patients presented with clinical symptoms in the myocardial injury group (chest discomfort in 4 cases, non-compressive precordial chest pain in 1 case, dyspnea in 2 cases). In the multivariate analysis, advanced age, increased Lee index score, increased neutrophil granulocyte ratio, decreased left ventricular ejection fraction (LVEF), increased interventricular septum were independent risk factors for myocardial injury. Conclusion In conclusion, advanced age, increased Lee index, increased neutrophil granulocyte ratio, decreased left ventricular ejection fraction, and increased ventricular septum were independent risk factors for preoperative myocardial injury in patients with gastrointestinal tumors. The proportion of clinical symptoms in gastrointestinal tumor patients with myocardial injury was low, indicating the necessity to closely monitor the cardiac status of individuals with gastrointestinal tumors.

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“…Abdominal surgery is common in elderly patients. Previous studies have shown that elderly patients are prone to postoperative cardiovascular complications due to the stress response caused by abdominal surgery, with a signi cantly extended length of hospital stay and increased reoperation [9,10].…”

mentioning

confidence: 99%

Impact of neuromuscular block on MINS incidence in the early postoperative stage of elderly patients undergoing laparoscopic colorectal cancer resection: A Randomized Controlled Study

An,

Wang,

et al. 2023

Preprint

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Background Myocardial injury after non-cardiac surgery (MINS) is a common and serious complication in elderly patients. This study investigates the impact of neuromuscular block on the MINS incidence and other cardiovascular complications in the early postoperative stage of elderly patients undergoing laparoscopic colorectal cancer resection. Methods 70 elderly patients who underwent laparoscopic colorectal cancer resection were separated into the deep neuromuscular block group and moderate neuromuscular block group for 35 cases in each group (n = 1:1). The deep neuromuscular block group maintained train of four (TOF) = 0, post-tetanic count (PTC) 1–2, and the moderate neuromuscular block group maintained TOF = 1–2 during the operation. Sugammadex sodium was used at 2 mg/kg or 4 mg/kg for muscle relaxation antagonism at the end of surgery. Postoperative follow-up was performed to compare MINS incidence and other cardiovascular complications during the first 7 days after surgery. Results MINS were not observed in both groups. The highest incidence of postoperative cardiovascular complications was lower limbs deep vein thrombosis (11.4%). The numeric rating scale score in the deep neuromuscular block group was lower than the moderate neuromuscular block group 72 h after surgery (P = 0.018). The operation time in the deep neuromuscular block group was longer (P = 0.008), the dosage of propofol and remifentanil was less (P = 0.043; P < 0.001), and the length of hospital stay was shorter than the moderate neuromuscular block group (P = 0.028). Conclusions Maintaining different degrees of the neuromuscular block under TOF guidance did not change the MINS incidence within 7 days after surgery in elderly patients who underwent laparoscopic colorectal cancer resection. Trial registration The present study was registered in the Chinese Clinical Trial Registry (10/02/2021, ChiCTR2100043323).

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Myocardial injury in elderly patients after abdominal surgery

Cited by 4 publications

References 23 publications

Risk factors for 28-day mortality in patients with sepsis-related myocardial injury in intensive care units

Risk factors for 28-day mortality in patients with sepsis-related myocardial injury in intensive care units

Risk factors of preoperative myocardial injury in patients with gastrointestinal tumors

Impact of neuromuscular block on MINS incidence in the early postoperative stage of elderly patients undergoing laparoscopic colorectal cancer resection: A Randomized Controlled Study

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