Perioperative Major Adverse Cardiovascular Events and Acute Kidney Injury: Is Routine Postoperative Monitoring Indicated?

Purpose of Review Major adverse cardiovascular events (MACE) and acute kidney injury (AKI) are common perioperative complications which are strongly associated with poor patient outcomes. This review aims to provide an update on the clinical relevance of perioperative MACE and AKI and to discuss perioperative management, focusing on the importance and role of postoperative monitoring. Recent Findings Previous studies demonstrated that myocardial injury is associated with poor patient outcomes. Recent guidelines recommend troponin measurements for high-risk patients undergoing major noncardiac surgery. Perioperative AKI is associated with increased length of stay and increased costs. Hypotension is common in the intraoperative and postoperative periods and is strongly associated with MACE and AKI. Continuous vital sign monitoring rather than traditional intermittent monitoring reduces the frequency and severity of hypotensive episodes, facilitating clinician intervention earlier. Summary Routine perioperative troponin and creatinine surveillance can be cost-effective and improve patient safety. Early detection of the hemodynamic events through continuous vital sign monitoring, combined with effective interventions, is expected to reduce serious postoperative complications.