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SHR Neuro Krebs Kardio Lipid

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 [OPEN ACCESS]
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Autor/innen der Med Uni Graz:
Baumann Anneliese
Farzi Sylvia Ingrid
Gumpert Rainer
Höfler Bernd
Mahla Elisabeth
Marko Thomas
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
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