British journal of anaesthesia
-
Review Meta Analysis
Troponin elevations after non-cardiac, non-vascular surgery are predictive of major adverse cardiac events and mortality: a systematic review and meta-analysis.
Patients undergoing non-cardiac, non-vascular surgery are at risk of major cardiovascular complications. In non-cardiac surgery, troponin elevation has previously been shown to be an independent predictor of major adverse cardiac events and postoperative mortality; however, a majority of studies have focused on vascular surgery patients. The aim of this meta-analysis was to determine whether troponin elevation is a predictor of major adverse cardiac events and mortality within 30 days and 1 yr after non-cardiac, non-vascular surgery. ⋯ Postoperative myocardial injury is an independent predictor of major adverse cardiac events and mortality within 30 days and 1 yr after non-cardiac, non-vascular surgery. The meta-analysis provides evidence that supports troponin monitoring as a cardiovascular risk stratification tool.
-
In 2007, the multidisciplinary European Task Force for Advanced Bleeding Care in Trauma published guidelines for the management of the bleeding trauma patient. The present study aimed to assess compliance with the European guidelines during the first 24 h in a level I trauma centre and to determine whether compliance impacts mortality. ⋯ We found that compliance with protocols based on European guidelines impacts trauma outcome, because patient compliance was associated with survival. Further work is needed to improve adherence to these guidelines, with ongoing monitoring to ensure best practice and optimal patient outcome.
-
Anaesthetic journals frequently publish studies comparing measurement methods. A common method of analysis is the Bland and Altman plot, which relates the difference between paired measurements to the mean of the pair. Previous reviews have shown that key data are often omitted from reports using this method of analysis, and the analysis of more complex data is frequently insufficient. ⋯ Bland and Altman analysis remains poorly reported. Our formal list of key criteria will assist authors in providing all the relevant features of a study. We explain errors that may be made in reporting, and suggest methods for analysis, including easily available software.