Journal of orthopaedic trauma
via Europe PMC
Preoperative High-Sensitivity Troponin and Risk of In-Hospital Mortality and Cardiac Events After Hip Fracture Surgery.
Touré A, Okafor K, Medilien B, +5 more, Schenker ML.
AI summary — for doctors, generated from the abstract only
Elevated preoperative high-sensitivity troponin independently predicted in-hospital cardiac events and death after hip fracture surgery, with troponin above 100 ng/L marking the highest risk.
What was studied
Retrospective single trauma-centre cohort (2020-2024) of 510 hip fracture patients with preoperative hs-cTn, assessing the composite of in-hospital cardiac event or death across troponin and surgical-delay categories.
Key findings
- 35 patients (6.9%) had the composite outcome
- Composite rate was 4.5% with normal troponin, 10.3% with elevated and 35.7% with significantly elevated troponin
- Elevated troponin remained independently associated with outcomes, independent of surgical delay
Clinical relevance
Preoperative troponin offers a simple risk marker to guide perioperative counselling and cardiac optimisation in hip fracture.
Who should care
Limitations
Retrospective single-centre cohort with few events in the high-troponin group (28 patients), giving imprecise estimates.
Check preoperative hs-troponin and treat values above 100 ng/L as high risk, involving cardiology or anaesthesia early.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objectives
To evaluate whether preoperative high-sensitivity cardiac troponin (hs-cTn) elevation predicted in-hospital cardiac events and mortality after hip fracture surgery, and whether surgical delay modified this relationship.
Design
Retrospective cohort study.
Setting
Single Level 1 trauma center in the United States.
Patient selection criteria
Adult patients who underwent hip fracture surgery between January 1, 2020, and December 31, 2024, and had a preoperative hs-cTn measurement as part of routine perioperative assessment were included.
Outcome measures and comparisons
The primary outcome was a composite of in-hospital cardiac event or mortality. Secondary outcomes were in-hospital mortality and in-hospital cardiac events analyzed separately. Outcomes were compared across preoperative troponin categories defined as normal (100 ng/L), and across surgical delay categories defined as 48 hours.
Results
A total of 510 patients were included. The mean age was 76.3 ± 14.1 years, and 291 patients (57.1%) were female. Preoperative troponin was normal in 424 patients (83.1%), elevated in 58 patients (11.4%), and significantly elevated in 28 patients (5.5%). Thirty-five patients (6.9%) experienced the composite outcome. The composite outcome occurred in 19 of 424 patients (4.5%) with normal troponin, 6 of 58 patients (10.3%) with elevated troponin, and 10 of 28 patients (35.7%) with significantly elevated troponin ( P < 0.001). Mortality occurred in 8 of 424 patients (1.9%), 2 of 58 patients (3.4%), and 3 of 28 patients (10.7%), respectively ( P = 0.015). Cardiac events occurred in 13 of 424 patients (3.1%), 4 of 58 patients (6.9%), and 9 of 28 patients (32.1%), respectively ( P < 0.001). In adjusted models, elevated hs-cTn was associated with increased odds of the composite outcome (odds ratio 4.4, 95% confidence interval 1.1-17.9, P = 0.038), and significantly elevated troponin was associated with higher odds of the composite outcome (odds ratio 16.1, 95% confidence interval 3.6-72.4, P < 0.001). Higher American Society of Anesthesiologists class independently predicted the composite outcome and mortality, and longer length of stay was associated with cardiac events.
Conclusions
Preoperative hs-cTn elevation was independently associated with in-hospital cardiac events and mortality after hip fracture surgery. Troponin levels greater than 100 ng/L identified patients at highest risk, independent of surgical delay.
Level of evidence
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
DOI
10.1097/bot.0000000000003241
PMID
42390346
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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