Department of Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, AB, Canada.
Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Anaesthesia. 2020 Jan;75 Suppl 1:e165-e173. doi: 10.1111/anae.14920.
Peri-operative risk estimation has traditionally focused on assessing the likelihood of postoperative morbidity and mortality using pre-operative functional assessment. Although this strategy is currently recommended by most major society guidelines, contemporary evidence suggests that cardiac biomarker measurement has important advantages over pre-operative functional assessment. These advantages include superior predictive discrimination and inclusion of the postoperative course in risk estimation. In this review, we provide an overview of the evidence supporting the peri-operative utilisation, compare risk estimation methods and discuss which patients may benefit most from cardiac biomarker screening. We also discuss protocols for biomarker screening and management of patients with abnormal results.
围手术期风险评估传统上侧重于使用术前功能评估来评估术后发病率和死亡率的可能性。尽管目前大多数主要学会指南都推荐这种策略，但现代证据表明，心脏生物标志物测量比术前功能评估具有重要优势。这些优势包括更好的预测区分度以及将术后过程纳入风险评估。在这篇综述中，我们提供了支持围手术期使用的证据概述，比较了风险评估方法，并讨论了哪些患者可能从心脏生物标志物筛查中获益最大。我们还讨论了生物标志物筛查方案以及异常结果患者的管理。
