Division of Orthopedic Surgery, Department of Surgery, London Health Sciences Centre, University Hospital, London, Ontario, Canada.
J Arthroplasty. 2024 Sep;39(9S1):S67-S72. doi: 10.1016/j.arth.2024.05.077. Epub 2024 Jun 1.
The aim of the study was to analyze the Canadian Cardiovascular Society (CCS) guidelines for routine postoperative troponin testing after elective total hip arthroplasty (THA) to reduce the mortality rate resulting from myocardial injury. The purpose of this study was to assess the prognostic relevance of implementing these guidelines to minimize cardiac events in patients undergoing elective THA.
Patients who underwent THA surgery in 2020 were included in the study. The inclusion criteria were elective THA patients aged ≥45 years, while emergency, revision, and simultaneous bilateral THA surgeries were excluded. The patients were categorized into 4 groups based on the CCS guidelines.
The study included 669 patients who had an average age of 67 years. There were 43 patients (6.4%), who experienced a rise in troponin levels ≥30 ng/L and developed myocardial injury after noncardiac surgery. Among these patients, 8 developed cardiac complications, and one experienced a serious cardiac event that resulted in death. Notably, there was a significant increase in the length of hospital stay for patients who received the postoperative screening protocol.
The implementation of the CCS guidelines for routine postoperative troponin testing in elective THA surgery did not significantly decrease the rate of cardiac events or mortality.
本研究旨在分析加拿大心血管学会（CCS）关于择期全髋关节置换术后常规术后肌钙蛋白检测的指南，以降低心肌损伤导致的死亡率。本研究旨在评估实施这些指南对减少择期全髋关节置换术患者心脏事件的预后相关性。
纳入 2020 年接受全髋关节置换术的患者。纳入标准为年龄≥45 岁的择期全髋关节置换术患者，排除急诊、翻修和同期双侧全髋关节置换术患者。根据 CCS 指南将患者分为 4 组。
研究纳入 669 例患者，平均年龄为 67 岁。有 43 例（6.4%）患者在非心脏手术后肌钙蛋白水平升高≥30ng/L 并发生心肌损伤。其中 8 例出现心脏并发症，1 例出现严重心脏事件导致死亡。值得注意的是，接受术后筛查方案的患者的住院时间显著延长。
在择期全髋关节置换术中实施 CCS 指南进行常规术后肌钙蛋白检测并未显著降低心脏事件或死亡率的发生率。
