Evidence map›Paper›PMID 35386054›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2022

Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario.

Paymon M Azizi, Duminda N Wijeysundera, Harindra C Wijeysundera, Peter C Austin, Angela Jerath, Lu Han, Maria Koh, Dennis T Ko

Open access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Effect of a national guideline on postoperative troponin surveillance: a retrospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024
    Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Paymon M AziziInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Duminda N WijeysunderaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Harindra C WijeysunderaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Peter C AustinInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Angela JerathICES, Toronto, ON, Canada.
Lu HanICES, Toronto, ON, Canada.
Maria KohICES, Toronto, ON, Canada.
Dennis T KoInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. dennis.ko@ices.on.ca.ORCID http://orcid.org/0000-0001-6840-8051
Sunnybrook Health Science Centre · CAUniversity of Toronto · CASt. Michael's Hospital · CA

Funding

CIHR FDN 154333
6 · The paper itself

Abstract

backgroundInternational practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial infarction and myocardial injury after noncardiac surgery. To gain insights into current testing patterns, we evaluated predictors of routine troponin testing after three commonly performed major noncardiac surgeries.

methodsWe conducted a population-based historical cohort study of adults having major orthopedic, colorectal, or vascular surgery in Ontario, Canada from 1 January 2010 to 31 December 2017. We used hierarchical logistic regression modelling to assess the association of patient, surgery, and hospital factors with postoperative troponin testing, while accounting for clustering at the hospital level. We characterized hospital-level variation by the intraclass correlation coefficient (ICC), which was adjusted for various characteristics.

resultsThe cohort included 176,454 eligible patients. Hospital-specific adjusted testing rates ranged from 0-20.1% for orthopedic surgery, 0-43.8% for colorectal surgery, and 19.6-88.0% for vascular surgery. Older age, urgent surgery status, and surgery duration were consistently associated with higher rates of testing for all three surgeries. Higher Revised Cardiac Risk Index scores were associated with higher odds of testing for orthopedic and colorectal surgery, but not for vascular surgery. Even after adjustment, the ICCs were 9.2%, 7.4%, and 24.1% for orthopedic, general, and vascular surgery, respectively.

conclusionsTroponin testing varied substantially across hospitals for selected major noncardiac surgery procedures even after accounting for differences in patient-level cardiac risk factors. Our observations lend support to a more standardized approach for troponin testing after noncardiac surgery.

Indexed as

Myocardial InfarctionTroponinAdultCohort StudiesHumansOntarioPostoperative ComplicationsRisk FactorsTroponinmyocardial injurynoncardiac surgerytroponin

Identifiers

PMID35386054
OpenAlexW4225603582

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.