Elevated preoperative troponin T in geriatric hip fracture patients: its value in predicting adverse cardiac events
10.3760/cma.j.cn101721-20250630-00274
- VernacularTitle:老年髋关节骨折患者术前肌钙蛋白T升高对不良心血管事件评估价值
- Author:
Yue BI
1
;
Bo GAO
;
Xiaoqin WEN
;
Jie WANG
Author Information
1. 天津市天津医院心内一科，天津 300000
- Publication Type:Journal Article
- Keywords:
Hip fracture;
Troponin T;
Adverse cardiovascular events;
The elderly
- From:
Clinical Medicine of China
2025;41(6):401-406
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of elevated preoperative troponin T (TnT) in predicting perioperative adverse cardiac events in geriatric hip fracture patients.Methods:A total of 273 elderly patients undergoing surgical treatment for hip fracture at Department of Cardiology, Tianjin Hospital between January 2024 and December 2024 were enrolled. Basic demographic information was recorded, and preoperative TnT levels were measured. Patients with elevated preoperative TnT ( n=114) were enrolled into the elevated group, while those with normal TnT ( n=159) were enrolled into the normal group. Fracture types included femoral neck fracture ( n=141) and intertrochanteric fracture ( n=132). The impact of elevated preoperative TnT on perioperative major adverse cardiovascular events (MACEs), as well as the influence of different fracture types on MACEs, were analyzed. Normally distributed continuous data were expressed as Mean±SD and compared by independent samples t-test. Categorical data were expressed as case(%) and compared by χ2 test. Multivariate binary logistic regression analysis was performed. The predictive value of TnT for MACEs was assessed by plotting the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC). Results:The incidence of perioperative MACEs was significantly higher in the elevated TnT group (21.9%, 25/114) compared to the normal TnT group (3.1%, 5/159), with a statistically significant difference ( χ2=23.95, P<0.001). The comparison of postoperative MACEs incidence between different fracture types showed no statistically significant difference [12.1% (17/141) vs. 9.8% (13/132)] ( χ2=0.34, P=0.560). Multivariate binary logistic regression analysis indicated that elevated TnT level ( OR=8.633, 95% CI: 3.117-23.911, P<0.001) was an independent risk factor for perioperative major adverse cardiovascular events (MACEs), increasing the risk by 7.633 times compared to patients with normal TnT. A TnT threshold of ≥0.028 μg/L predicted MACEs with a sensitivity of 0.600 and specificity of 0.954 (AUC=0.839, 95% CI: 0.751-0.926, P<0.05). Conclusion:Troponin T can serve as an independent predictor of perioperative adverse cardiovascular events in elderly patients undergoing surgery for hip fracture and plays a crucial role in the perioperative cardiovascular risk assessment of these patients.
