Key result
Elevated pre-operative BNP affects ~67% of surgically treated chronic subdural hematoma patients and links to AF.
Why the study?
The study was conducted to analyze BNP serum levels and their clinical implications in patients with chronic subdural hematoma.
What is the pattern of brain natriuretic peptide (BNP) serum levels in patients undergoing surgery for symptomatic chronic subdural hematoma?
Cohort (n=100)
No
What is the pattern of brain natriuretic peptide (BNP) serum levels in patients undergoing surgery for symptomatic chronic subdural hematoma?
p-value: p=<0.001
BNP serum levels are frequently elevated in patients with chronic subdural hematoma without heart failure, increase further post-operatively, and are associated with atrial fibrillation and antithrombotic therapy.
Elevated BNP in chronic subdural hematoma may signal atrial fibrillation comorbidity; leaves open its utility for perioperative cardiac risk stratification.
The purpose of this study was to analyze brain natriuretic peptide (BNP) serum levels of patients with chronic subdural hematoma (cSDH) and their clinical implication. Patients with cSDH who underwent surgery in our department between November 2016 and October 2019 were eligible for enrollment in the study. Patients with recurrent bleedings, traumatic brain injury, cSDH associated with other intracranial pathologies, and those with a history of congestive heart failure, renal or endocrine disease were excluded. We measured BNP serum levels pre- and post-operatively and at discharge. The BNP values were analyzed with respect to patient medical history and neurological condition. The Glasgow Coma Scale score and the modified Rankin Scale score classified the clinical and neurological condition at the time of admission and discharge, respectively. The data of 100 surgically treated patients with cSDH (mean age 73.2, range 42 − 94 years, male/female 3.5:1) were analyzed. Pre-operative BNP serum levels (BNP-1) were elevated in 67% of the patients ( n = 67; median = 101.6 pg/mL; p < 0.001). These serum levels increased after surgery (p < 0.001) and decreased thereafter ( p < 0.001), reaching a level at discharge (day 7) that was not statistically different from BNP-1 ( p > 0.05). In addition, elevated BNP-1 showed a significant statistical association with the presence of atrial fibrillation ( p < 0.01) and antiplatelet and/or anticoagulant therapy ( p < 0.01). This study provides new evidence regarding BNP serum levels and their secretion pattern in patients with cSDH. Whether BNP-1 can predict the long-term functional outcome of patients with cSDH is being investigated in this ongoing prospective study.
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Chihi et al. (2020) conducted a cohort in Symptomatic chronic subdural hematoma (cSDH) (n=100). Brain natriuretic peptide (BNP) serum levels was evaluated on Elevated pre-operative BNP serum levels (BNP-1) (p=<0.001). Pre-operative BNP serum levels were elevated in 67% of surgically treated patients with chronic subdural hematoma (median 101.6 pg/mL; p<0.001) and were associated with atrial fibrillation.
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