High-sensitivity troponin T predicts perioperative adverse events in patients undergoing neurosurgical procedures

INTRODUCTION: Previous studies have shown that troponin is a valuable predictor of perioperative complications after non-cardiac surgery. However, the relationship of the preoperative troponin level with perioperative adverse events has not been well described in patients undergoing neurosurgical procedures. The aim of this study was to evaluate the impact of the preoperative high-sensitivity cardiac troponin T (hs-cTnT) level on the outcome of patients who underwent neurosurgery.
METHODS: The records of 2519 patients who were over 18 years of age and underwent elective neurosurgery between December 2014 and December 2018 were retrospectively evaluated. Patient medical and demographic data and the results of routine preoperative laboratory tests, including the hs-cTnT level, were collected to assess a potential association between these factors and perioperative adverse events.
RESULTS: Perioperative adverse events occurred in 251 (10.0%) patients. Older patients and those with more comorbid conditions tended to have a higher rate of perioperative adverse events. The preoperative hs-cTnT level was significantly higher in the individuals who experienced a complicated in-hospital course than in those who did not (21.6±8.2 ng/L vs 6.3±3.1 ng/L; p<0.001). Multivariate analysis indicated that age (odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.16-4.35; p<0.01), the presence of diabetes (OR: 3.13; 95% CI: 1.15-6.32; p=0.004), and a preoperative hs-cTnT level of >18.3 ng/L (OR: 4.51, 95% CI: 2.34–7.82; p<0.001) were significant and independent predictors of perioperative adverse events.
DISCUSSION AND CONCLUSION: The results of this study indicated that a higher preoperative hs-cTnT level was associated with perioperative adverse events in adult patients undergoing elective neurosurgery.