Key result
An increase in GDF-15 levels >60% at the end of surgery was significantly associated with postoperative pulmonary complications (HR 5.9; 95% CI 1.73-20.09).
Why the study?
Preoperative risk prediction in thoracic surgery remains difficult because most models do not include perioperative factors, prompting evaluation of perioperative GDF-15 kinetics to predict postoperative pulmonary complications.
Do perioperative GDF-15 serum kinetics predict postoperative pulmonary complications in adult patients undergoing non-cardiac thoracic surgery?
Cohort (n=101)
No
Do perioperative GDF-15 serum kinetics predict postoperative pulmonary complications in adult patients undergoing non-cardiac thoracic surgery?
Perioperative increases in GDF-15 serum levels can help stratify the risk of postoperative pulmonary complications in patients undergoing non-cardiac thoracic surgery.
Answers are grounded in this paper and cite their sources.
Perioperative GDF-15 kinetics may aid PPC risk stratification in thoracic surgery; hypothesis-generating and requires prospective validation.
OBJECTIVES: Preoperative risk prediction in thoracic surgery remains difficult for individual patients, as most risk assessment models do not include perioperative factors. We hypothesized that the perioperative kinetics of growth differentiation factor 15 (GDF-15) in patients' serum predicts the risk of postoperative pulmonary complications. DESIGN: A single-center prospective observational cohort study. SETTING: University hospital. PARTICIPANTS: One hundred one consecutive adult patients undergoing non-cardiac thoracic surgery. INTERVENTIONS: None. MEASUREMENTS: The primary endpoint, postoperative pulmonary complications (PPC), was a composite endpoint consisting of pneumonia, severe respiratory failure, reintubation, and Acute respiratory distress syndrome. Pre- and postoperative serum GDF-15 measurements were performed. MAIN RESULTS: During the median postoperative hospital stay of 8.7 days (median [IQR 6.6-10.4]), 23 patients with PPC were identified. Compared to the preoperative baseline, significantly higher mean concentrations of GDF-15 were observed in patients with PPC than in patients without PPC at the end of surgery (4371 [IQR 2560-6991] v 2776 [IQR 2004-3721] pg/mL, p = 0.003) and 72 hours after surgery (5040 [IQR 3482-6527] v 2810 [2178-3935] pg/mL, p < 0.001) with a significant association of the increase in GDF-15 and the hazard ratio for PPC. In a multivariate Cox proportional hazards model, an increase in GDF-15 levels >60% at the end of surgery (hazard ratio 5.9 (95% confidence interval 1.73-20.09) and an increase of >68% 72 hours after surgery (hazard ratio) 4.1 (95% confidence interval 1.36-12.62) was significantly associated with PPC after thoracic surgery. CONCLUSIONS: In patients undergoing thoracic surgery, perioperative assessment of GDF-15 serum kinetics helps to stratify the postoperative risk of PPC.
No takes yet. Share an insight, caveat, or question.
Semmelmann et al. (2025) conducted a cohort in Non-cardiac thoracic surgery (n=101). Increase in GDF-15 levels >60% at the end of surgery vs. Increase in GDF-15 levels ≤60% or baseline was evaluated on Postoperative pulmonary complications (PPC), a composite of pneumonia, severe respiratory failure, reintubation, and acute respiratory distress syndrome (HR 5.9, 95% CI 1.73-20.09). An increase in GDF-15 levels >60% at the end of surgery was significantly associated with postoperative pulmonary complications (HR 5.9; 95% CI 1.73-20.09).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: