The Effects of Troponin I Surveillance Among Patients Undergoing Acute High-risk Abdominal Surgery

Study Overview
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Brief Summary
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Treatment of disorders such as gastrointestinal tract (GI) perforation, ischemia and obstruction often require acute high-risk abdominal surgery, which is associated with a high risk of complications such as myocardial injury after non-cardiac surgery (MINS) and mortality. The majority of patients with MINS will not experience any symptoms, and thus MINS remains undetected without routine troponin measurements. The investigators hypothesized that implementing surveillance with troponin I as a standard care might be useful as risk stratification, and that increased surveillance, examinations, and subsequent individually based medical interventions, might improve the outcomes for patients with MINS.

Official Title
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The Effects of Troponin I Surveillance Among Patients Undergoing Acute High-risk Abdominal Surgery

Conditions
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Abdomen, Acute, Myocardial Injury After Non-cardiac Surgery, Troponin I, Myocardial Injury, Emergency Surgery

Intervention / Treatment
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* Diagnostic Test: Troponin I


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eligible patients were 18 years or older Undergoing surgery for gastrointestinal perforation, obstruction, mesenterial ischemia or necrosis, or anastomotic leakage. Exclusion Criteria: Not undergoing surgery for one of the conditions above

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients not undergoing troponin I surveillance<br>Patients undergoing acute high-risk abdominal surgery during the period February 1, 2018, to February 28, 2019. No troponin I measurements were made. | |
| Patients undergoing troponin I surveillance<br>Patients undergoing acute high-risk abdominal surgery during the period March 1, 2019, to February 28, 2021 as well as postoperative troponin I surveillance . | Diagnostic Test: Troponin I<br>* Troponin I were measured 6-12 hours postoperatively and on each of the succeeding four postoperative days for patients operated March 1, 2019, to February 28, 2021. Patients with increased troponin I levels were assessed regarding symptoms of myocardial ischaemia including electrocardiography. Each patient was individually assessed, and relevant treatment and follow-up were planned in collaboration between surgeons, cardiologists, and anaesthesiologists.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| compare the mortality rate before and after implementing troponin I surveillance | compare the 30-, 90-, and 365-day mortality rate after acute hugh-risk abdominal surgery in patients undergoing postoperative troponin I surveillance and subsequent intervention with a historical group of patients not undergoing troponin I surveillance. | 30-, 90-, and 365-day |