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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Farzi, S; Stojakovic, T; Marko, T; Sankin, C; Rehak, P; Gumpert, R; Baumann, A; Höfler, B; Metzler, H; Mahla, E.
Role of N-terminal pro B-type natriuretic peptide in identifying patients at high risk for adverse outcome after emergent non-cardiac surgery.
Br J Anaesth. 2013; 110(4):554-560
Doi: 10.1093/bja/aes454
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- Leading authors Med Uni Graz
- Farzi Sylvia Ingrid
- Co-authors Med Uni Graz
- Baumann Anneliese
- Gumpert Rainer
- Höfler Bernd
- Mahla Elisabeth
- Marko Thomas Peter
- Metzler Helfried
- Rehak Peter
- Sankin Corinna
- Stojakovic Tatjana
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- Abstract:
- Background. Patients undergoing emergency surgery continue to be at very high risk, but accurate risk identification for the individual patient remains difficult. This study tested the usefulness of perioperative N-terminal pro B-type natriuretic peptide (NT-proBNP) for in-hospital and long-term risk stratification. Methods. We conducted a prospective single-centre observational cohort study in an Austrian university hospital. Two hundred and ninety-seven consecutive patients >50 yr of age undergoing a variety of emergency non-cardiac procedures were included. The primary endpoint was a composite of non-fatal myocardial infarction (MI), acute heart failure, or death between index surgery and 3 yr follow-up. The secondary endpoint was in-hospital major adverse cardiac events (MACE), defined as non-fatal MI, acute heart failure, or cardiac death. Results. During a median follow-up of 34 months (inter-quartile range: 16-39), 31% of subjects reached the primary endpoint. A preoperative NT-proBNP >= 725 pg ml(-1) was associated with a 4.8-fold univariate relative risk [95% confidence interval (CI): 3.1-7.6] and a postoperative NT-proBNP >= 1600 pg ml(-1) was associated with a four-fold univariate relative risk (95% CI: 2.7-6.2) for reaching the primary endpoint. Moreover, preoperative NT-proBNP remained a significant and independent (hazards ratio 1.91, 95% CI 1.08-3.37, P = 0.027) predictor in a multivariate Cox proportional hazards model. A preoperative NT-proBNP >= 1740 pg ml(-1) was associated with a 6.9-fold univariate relative risk (95% CI: 3.5-13.4) for MACE during the index hospital stay, but did not remain significant in a multivariate logistic regression model. Conclusions. Preoperative NT-proBNP can help identify patients at high risk for adverse long-term outcome after emergency surgery.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aged, 80 and over -
- Biological Markers - blood
- Comorbidity -
- Electrocardiography -
- Emergency Medical Services -
- Enzyme-Linked Immunosorbent Assay -
- Female -
- Follow-Up Studies -
- Hematocrit -
- Hospital Mortality -
- Humans -
- Kaplan-Meier Estimate -
- Male -
- Middle Aged -
- Myocardial Infarction - epidemiology Myocardial Infarction - mortality
- Natriuretic Peptide, Brain - blood
- Peptide Fragments - blood
- Postoperative Complications - epidemiology Postoperative Complications - mortality
- Postoperative Period -
- Preoperative Period -
- ROC Curve -
- Reproducibility of Results -
- Risk Assessment -
- Surgical Procedures, Operative - adverse effects Surgical Procedures, Operative - mortality
- Survival Analysis -
- Treatment Outcome -
- Troponin T - blood
- Find related publications in this database (Keywords)
- B-type natriuretic peptide (BNP)
- emergency surgery
- postoperative complications
- risk stratification