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http://hdl.handle.net/11375/13049
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DC Field | Value | Language |
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dc.contributor.advisor | Devereaux, Philip J | en_US |
dc.contributor.advisor | Thabane, Lehana | en_US |
dc.contributor.advisor | Guyatt, Gordon | en_US |
dc.contributor.author | Rodseth, Reitze | en_US |
dc.date.accessioned | 2014-06-18T17:02:06Z | - |
dc.date.available | 2014-06-18T17:02:06Z | - |
dc.date.created | 2013-06-07 | en_US |
dc.date.issued | 2013-10 | en_US |
dc.identifier.other | opendissertations/7881 | en_US |
dc.identifier.other | 8932 | en_US |
dc.identifier.other | 4208002 | en_US |
dc.identifier.uri | http://hdl.handle.net/11375/13049 | - |
dc.description.abstract | <p><strong>Background: </strong>Myocardial injury after noncardiac surgery (MINS) increases the risk of 30-day mortality. Intraoperative hemodynamic events (i.e., tachycardia, bradycardia, hypotension, and hypertension) may contribute to developing MINS.</p> <p><strong>Objectives: </strong>To determine if the addition of the duration spent within predefined intraoperative systolic blood pressure (BP; mmHg) (i.e.,160-199 and ≥200) and heart rate (HR; bpm) (i.e.,100-140 and >140) hemodynamic bands improved the prediction of Day 1 MINS (i.e., postoperative troponin T elevation ≥0.03 ng/ml within the first day after surgery) beyond preoperative risk model prediction.</p> <p><strong>Methods: </strong> Prospective observational data was used to developed a baseline risk model to predict Day 1 MINS. Preoperative HR, systolic BP, and hemoglobin as well as intraoperative duration spent within each predefined hemodynamic band were explored to identify optimal thresholds for the prediction of Day-1 MINS. Preoperative variables were added to the baseline risk model to create a preoperative model. Intraoperative variables were then added to the preoperative risk model to create the final model. Models were compared using discrimination (c-statistic) and net reclassification index (NRI).</p> <p><strong>Results: </strong>Adding preoperative hemoglobin ≤105 g/dL, systolic BP110 improved baseline model discrimination (0.783 to 0.792, p5min; HR >100 for >147min; systolic BP59min and systolic BP >160 for >42min further improved discrimination (0.8; p</p> <p><strong>Conclusion:</strong> Adding intraoperative hemodynamic durations significantly improved Day-1 MINS model discrimination and risk stratification compared to the baseline risk model.</p> | en_US |
dc.subject | surgery | en_US |
dc.subject | risk | en_US |
dc.subject | myocardial infarction | en_US |
dc.subject | perioperative risk stratification | en_US |
dc.subject | intraoperative hemodynamics | en_US |
dc.subject | Anesthesiology | en_US |
dc.subject | Cardiology | en_US |
dc.subject | Clinical Epidemiology | en_US |
dc.subject | Anesthesiology | en_US |
dc.title | INTRAOPERATIVE HEMODYNAMIC PREDICTORS OF EARLY POSTOPERATIVE TROPONIN ELEVATION AND MORTALITY | en_US |
dc.type | thesis | en_US |
dc.contributor.department | Health Research Methodology | en_US |
dc.description.degree | Master of Health Sciences (MSc) | en_US |
Appears in Collections: | Open Access Dissertations and Theses |
Files in This Item:
File | Size | Format | |
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fulltext.pdf | 1.67 MB | Adobe PDF | View/Open |
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