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).
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.
Hazard Ratio: 5.9 (95% CI 1.73–20.09)
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 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.
Semmelmann et al. (Sat,) 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).
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