{"id":1809,"date":"2022-04-07T00:00:00","date_gmt":"2022-04-07T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/"},"modified":"2023-06-14T19:35:06","modified_gmt":"2023-06-14T23:35:06","slug":"troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/","title":{"rendered":"Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; International 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.<\/p>\n<p><strong>Methods<\/strong>  &#x2014; We 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.<\/p>\n<p><strong>Results<\/strong>  &#x2014; The cohort included 176,454 eligible patients. Hospital-specific adjusted testing rates ranged from 0&#x2013;20.1% for orthopedic surgery, 0&#x2013;43.8% for colorectal surgery, and 19.6&#x2013;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.<\/p>\n<p><strong>Conclusions<\/strong>  &#x2014; Troponin 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.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; International 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. Methods &#x2014; We conducted a population-based historical cohort study of adults [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[87],"class_list":["post-1809","journal_article","type-journal_article","status-publish","hentry","migration-helper-qa-sample-set-journal-articles-set-a"],"acf":{"citation":"Azizi PM, Wijeysundera DN, Wijeysundera HC, Austin PC, Jerath A, Han L, Koh M, Ko DT. <em>Can J Anaesth.<\/em> 2022; 69(5):572-81. Epub 2022 Apr 7.","source_url":"https:\/\/doi.org\/10.1007\/s12630-022-02219-y","ices_scientist":[1385,1132,1133,1277,1146,1140],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"3243028D-48F9-460B-B014-4D28C79DB7DC","sitecore_item_name":"Troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation","sitecore_field_values":"{\n  \"Title\": \"Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario\",\n  \"Short title\": \"Troponin testing after noncardiac\",\n  \"Summary\": \"The study observations lend support to a more standardized approach for troponin testing after noncardiac surgery.\",\n  \"Citation\": \"<p>Azizi PM, Wijeysundera DN, Wijeysundera HC, Austin PC, Jerath A, Han L, Koh M, Ko DT. <em>Can J Anaesth.<\/em> 2022; 69(5):572-81. Epub 2022 Apr 7. DOI: <a href=\"https:\/\/doi.org\/10.1007\/s12630-022-02219-y\" title=\"opens external link\">https:\/\/doi.org\/10.1007\/s12630-022-02219-y<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; International 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.<\/p>n<p><strong>Methods<\/strong>  &mdash; We 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.<\/p>n<p><strong>Results<\/strong>  &mdash; The cohort included 176,454 eligible patients. Hospital-specific adjusted testing rates ranged from 0&ndash;20.1% for orthopedic surgery, 0&ndash;43.8% for colorectal surgery, and 19.6&ndash;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.<\/p>n<p><strong>Conclusions<\/strong>  &mdash; Troponin 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.<\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{22E01D03-965E-4F09-9CC2-6BC40EC9403D}|{8C2597F4-2B41-4E87-9F28-6887C689651B}|{25E109B8-BCCB-4509-8BF2-D99CFA390739}|{B3827152-93D1-4FB2-B106-590CB331A264}|{5347DD83-0742-46B5-B0AC-4EF2A329F89E}\",\n  \"Posted Date\": \"20220407T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/April\/Troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario<\/title>\n<meta name=\"description\" content=\"Background &#x2014; International practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; International practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:35:06+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\\\/\",\"name\":\"ICES | Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2022-04-07T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:35:06+00:00\",\"description\":\"Background &#x2014; International practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario","description":"Background &#x2014; International practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario","og_description":"Background &#x2014; International practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-14T23:35:06+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/","name":"ICES | Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2022-04-07T04:00:00+00:00","dateModified":"2023-06-14T23:35:06+00:00","description":"Background &#x2014; International practice guidelines make different recommendations for postoperative troponin testing to detect perioperative myocardial","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/troponin-testing-after-noncardiac-surgery-a-population-based-historical-cohort-study-on-variation-and-factors-associated-with-testing-in-ontario\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Troponin testing after noncardiac surgery: a population-based historical cohort study on variation and factors associated with testing in Ontario"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/1809","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6742"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6733"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1140"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1146"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1277"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1133"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1132"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1385"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=1809"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=1809"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=1809"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=1809"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=1809"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}