Quality of Care After Joint Surgery May Affect Heart
FRIDAY, Aug. 27 (HealthDay News) -- The quality of care a
patient receives immediately after orthopedic surgery has a major
impact on long-term heart health, a new study shows.
A team of French researchers checked troponin levels in 378
patients for three days after they had orthopedic surgery, which
includes procedures such as joint replacement. Troponin is a
protein that's measured to determine whether physiologic stress
related to surgery has caused damage to the heart.
Dr. Sylvain Ausset, of Percy Military Hospital in Clamart,
France, and colleagues focused on troponin levels to detect
myocardial ischemia (commonly called angina), which correlated with
worse long-term cardiac outcomes. The researchers then modified
postoperative care to reduce events believed to lead to increased
episodes of angina based on elevated troponin levels. Doing so
lowered the incidence of cardiac problems months, and even years,
later, they found.
The methods used to improve quality of care included tighter
control of oxygen and glucose levels in patients' blood, along with
consistency and continuity of care as hospital staff monitored and
cared for patients, according to the report published in the
October issue of
"An improvement of quality of postoperative care results in a twofold decrease of postoperative myocardial ischemia and a fourfold decrease of major cardiac events later on," Ausset said in a news release from the American Society of Anesthesiologists.
The findings could lead to new or improved clinical guidelines,
according to an accompanying editorial written by Dr. Don
Poldermans, of Erasmus Medical Center in Rotterdam, the
The U.S. National Institute of Arthritis and Musculoskeletal
joint replacement surgery.
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