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Elevated Troponin: A Marker for Noncardiac Complications After Resection of Head and Neck Cancers
Author(s) -
McHugh Tobial,
Zhang Han,
Xie Michael,
Gupta Michael K.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28291
Subject(s) - medicine , troponin , incidence (geometry) , troponin i , multivariate analysis , head and neck cancer , cancer , surgery , cardiology , oncology , myocardial infarction , physics , optics
Objective To examine if troponin positivity (TP) in patients who undergo head and neck cancer mucosal resections (HNS) predicts noncardiac complications (NCC). Background Major HNSs are arduous operations that place stress on the patient's hemodynamic system. TP after noncardiac surgery previously has been shown in up to 25% of patients, which may signal cardiac complications (CC) or NCC. Although CC after HNS has been observed, no study has investigated the relationship of TP to NCC. Methods All patients who underwent HNS at a tertiary‐care cancer center from July 2014 to July 2016 were included and underwent postoperative troponin measurements as part of an institutional cardiac protocol. Comparative and multivariate regression analysis were used to compare TP and troponin‐negative (TN) patients for NCC. Results One hundred seventy‐two patients underwent HNS. Of those, 15% developed TP during the postoperative period. There was no significant difference between TP and TN for gender, tumor‐node‐metastasis staging, Charlson comorbidity index, and smoking status. Risk of NCC in TP was 73.1% versus 28.1% in TN ( P < 0.001). A significant difference ( P < 0.05) in wound complications, length of hospital stay (LOHS), and incidence of pneumonia was found between both groups. Nonparametric testing confirmed significant difference in pneumonia (Z = −3.469, P = 0.001) and LOHS (−3.110, P = 0.002). Multivariate regression analysis confirmed a significant difference in LOHS independent of CC (R 2 = 0.122, P < 0.0001). Conclusion TP is not an uncommon occurrence after HNS and is associated with statistically significant increases in wound complications, LOHS, and pneumonia. However, the overall significance of these findings remains unclear, and further research is warranted to determine if outcomes may be improved by closely monitoring these patients for TP. Level of Evidence 4 Laryngoscope , 130:2148–2152, 2020