A study published in the October issue of Anesthesiology is among the first to show that the quality of immediate postoperative care of orthopedic surgery patients has important effects on patients’ long-term cardiac outcomes.
“Looking at long-term outcome, especially for mortality, is currently the gold standard for postoperative care, but it is difficult to obtain this end-point, and obviously needs a fair amount of time to occur,” Sylvain Ausset, MD, from Percy Military Hospital in Clamart, France and lead author, stated in a press release. “What we sought was an indicator that would be quickly and easily available.”
Over a 3-year period, Ausset and colleagues measured troponin levels on the first 3 days after surgery in 378 orthopedic surgical patients to determine if there was any correlation between raised troponin levels and long-term cardiac outcomes.
Ausset concentrated on using troponin levels to detect myocardial ischemia, angina, the presence of which correlated with worse long-term cardiac outcomes.
The team then modified postoperative care to reduce the occurrence of events that were thought to lead to increased episodes of myocardial ischemia based on raised troponin levels. Reducing the incidence of myocardial ischemia, then, was found to be an important step in lowering the incidence of cardiac problems months and even years later.
“An improvement of quality of postoperative care results in a two-fold decrease of postoperative myocardial ischemia and a four-fold decrease of major cardiac events later on,” Ausset stated.