Quality of Care After Joint Surgery May Affect Heart Health

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, 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 Anesthesiology.

"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 Netherlands.

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