Key result
Pre-operative BNP levels predicted new postoperative cardiac events with an area under the curve of 0.85, where a value >170 pg/ml had 82% sensitivity and 79% specificity.
Why the study?
Does pre-operative BNP level predict postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery?
Observational (n=40)
Does pre-operative BNP level predict postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery?
Pre-operative BNP levels > 170 pg/ml show good sensitivity and specificity for predicting early postoperative cardiac events in patients undergoing major emergency non-cardiac surgery.
Answers are grounded in this paper and cite their sources.
May support preoperative BNP for risk stratification in emergency noncardiac surgery; hypothesis-generating and requires prospective validation.
B-type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesised that they would identify individuals at increased risk of complications and mortality following major emergency non-cardiac surgery. Forty patients were studied with a primary end-point of a new postoperative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all-cause mortality at 6 months. Pre-operative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p = 0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI = 0.72-0.98, p = 0.001). A pre-operative BNP value > 170 pg x ml(-1) has a sensitivity of 82% and a specificity of 79% for the primary end-point. In this small study, pre-operative BNP levels identify patients undergoing major emergency non-cardiac surgery who are at increased risk of early postoperative cardiac events. Larger studies are required to confirm these data.
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Cuthbertson et al. (2007) conducted an observational in Major emergency non-cardiac surgery (n=40). Pre-operative B-type natriuretic peptide (BNP) levels was evaluated on New postoperative cardiac event, and/or development of significant ECG changes, and/or cardiac death (AUC 0.85, 95% CI 0.72-0.98, p=0.001). Pre-operative BNP levels predicted new postoperative cardiac events with an area under the curve of 0.85, where a value >170 pg/ml had 82% sensitivity and 79% specificity.
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