Mortality in patients undergoing open aortoiliac surgery: prognostic value of troponin T in the immediate postoperative period.

BACKGROUND: Patients undergoing open aortoiliac surgery constitute a high-risk subgroup. The aim of this study was to evaluate the relationship between postoperative troponin T (TnT) elevation with the associated postoperative mortality, and mean hospital stay.

METHODS: This was a prospective observational study of consecutive patients who underwent open aortoiliac surgery during 2006. TnT levels in the first 72 hours after the operation, immediate mortality, postoperative care unit stay, and total postoperative hospital stay were recorded. Statistical analyses were performed with the program SPSS 14.0; the chi-square test (or the Fisher's exact test) was used for qualitative variables and the Mann-Whitney test for quantitative variables.

RESULTS: Of the 65 patients included in the study, postoperative TnT was elevated in 14 (21.5%) patients. No significant differences were found in age, sex, hypertension, dyslipidemia, smoking, diabetes mellitus, ischemic heart disease, heart failure, bronchopathy, or renal failure between groups. Mortality in patients with elevated TnT levels was significantly higher (42% compared with 3.92%; relative risk 10.93 +/- 0.76; p = 0.001). Likewise, their mean postoperative intensive care unit stay was significantly greater (23.21 +/- 6.96 days compared to 2.86 +/- 1.96; p < 0.001). This finding resulted in a significantly longer postoperative hospital stay (32.57 +/- 25.38 days compared with 12.47 +/- 2.21).

CONCLUSION: TnT level in the immediate postoperative period is a highly relevant indicator of prognosis in patients undergoing major vascular surgery.