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PTH-338 Postoperative troponin i elevation in patients undergoing major abdominal surgery
  1. S Duff1,
  2. A Macdonald2,
  3. J Sarma3,
  4. S Lavarello Munoz2
  1. 1General Surgery, University Hospital of South Manchester, Mnchester
  2. 2General Surgery
  3. 3Cardiology, University Hospital of South Manchester, Manchester, UK

Abstract

Introduction In the UK, there is an ageing general surgical population with increasing comorbidity. Most studies evaluating postoperative elevation in troponin-I have focussed on surgery in individuals known or suspected to be at high risk of atherosclerotic disease. We aimed to determine the rates of postoperative elevation of troponin-I in patients following elective and emergency major abdominal surgery. Early identification of these patients is vital as this may allow cardiac risk modification improving long-term survival.

Method One hundred patients were recruited. Demographic data was collected. Troponin-I was measured on day one and two postoperatively. If a raised troponin-I level was detected on either blood sample, an electrocardiogram was performed, the patient questioned about the presence of any symptoms and a prompt cardiology consultation was obtained.

Results Fifty-five men and forty-five women were recruited (mean age 70.3, range 45–90). Thirteen of the hundred patients (13%) had postoperatively elevated troponin-I levels on day 1 or 2. Postoperative troponin-I elevation was associated with an increased mean age (P = 0.012) and with increasing CEPOD category of surgery (P = 0.009). No statistically significant difference was seen between groups for P-POSSUM scores of morbidity (P = 0.07) or mortality (P = 0.067).

Conclusion Elevated postoperative troponin-I levels were identified in 13% of general surgical patients undergoing major abdominal surgery. All elevations were asymptomatic and not associated with any cardiological symptoms or ECG abnormality. Elderly patients undergoing emergency surgery are a high-risk group for perioperative cardiac damage which may contribute to the increased morbidity and risk of emergency general surgery.

Disclosure of interest None Declared.

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