Evidence mapPaperPMID 37973786Full record

Observational studyCanadian journal of anaesthesia = Journal canadien d'anesthesie2024

Effect of a national guideline on postoperative troponin surveillance: a retrospective cohort study.

Eva Alvarez Torres, Justyna Bartoszko, Selene Martinez Perez, Gordon Tait, Michael Santema, W Scott Beattie, Stuart A McCluskey, Wilton A van Klei

Open access · bronzeAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 2 countries.

Eva Alvarez TorresDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Justyna BartoszkoDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Selene Martinez PerezDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Gordon TaitDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Michael SantemaDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
W Scott BeattieDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Stuart A McCluskeyDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Wilton A van KleiDepartment of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada. wilton.vanklei@uhn.ca.ORCID 0000-0003-2665-1672
University Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to evaluate the effect of the 2017 Canadian Cardiovascular Society (CCS) guidelines on troponin surveillance after noncardiac surgery.

methodsThis was a single-centre, retrospective, observational study. Patients aged 40 yr or older undergoing intermediate- to high-risk elective noncardiac surgery between 2016 and 2021 were included. We compared the number and percentage of troponin tests ordered before and after the guidelines were published and compared patient characteristics, specifically cardiovascular comorbidity, using odds ratio's (OR) with 95% confidence intervals (CIs). Outcomes were myocardial injury, myocardial infarction (MI), and in-hospital mortality.

resultsThe cohort included 36,386 patients and the median age was 63 yr. Between 2016 and 2018, troponin surveillance was done in 2,461 (13%) of the 19,046 patients, compared with 2,398 (14%) of the 17,340 patients who had surgery between 2019 and 2021 (OR, 1.08; 95% CI, 1.02 to 1.15). Patients who had surgery in the second period had less cardiovascular comorbidity; the adjusted OR for troponin surveillance was 1.14 (95% CI, 1.07 to 1.21). In the two periods, troponin was elevated in 561 (2.9%) and 470 (2.7%) patients, an MI was documented in 54 (0.3%) and 36 (0.2%) patients, and 95 (0.5%) and 73 (0.4%) patients died, respectively. After adjustment for baseline differences in the two periods, the ORs for MI and mortality were 0.83 (95% CI, 0.54 to 1.27) and 0.88 (95% CI, 0.64 to 1.19), respectively.

conclusionAlthough the odds of troponin ordering were slightly but significantly higher after publication of the CCS guidelines, the odds for detecting an MI and for mortality did not change.

Indexed as

Myocardial InfarctionTroponinCanadaHumansMiddle AgedPostoperative ComplicationsRetrospective StudiesTroponinmyocardial infarctionmyocardial injurynoncardiac surgerypostoperativetroponin

Identifiers

PMID37973786
OpenAlexW4388718981

What Socratic 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 Socratic graph.