N-terminal fragment of pro-B-type natriuretic peptide is a predictor of cardiac events in high-risk patients undergoing acute hip fracture surgery
2009 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, ISSN 0007-0912, Vol. 103, no 2, 206-212 p.Article in journal (Refereed) Published
The aim of this investigation was to assess the incidence of elevated N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) and its relation to outcome defined as perioperative adverse cardiac events and all-cause mortality in high-risk patients undergoing non-elective surgery for hip fracture. A cohort of patients with hip fractures were extracted from a prospective observational study of high-risk patients (ASA class III or IV) undergoing emergency surgery. NT-proBNP and troponin I were measured before operation. An NT-proBNP greater than= 3984 ng litre(-1) was set as the cut-off level for significance. Perioperative adverse cardiac events and 30 day and 3 month mortality were recorded. Sixty-nine subjects were included. Thirty-four subjects (49%) had an NT-proBNP greater than= 3984 ng litre(-1) before surgery. Thirty-four subjects (49%) had a perioperative adverse cardiac event. Of these, 22 subjects (65%) had NT-proBNP above the diagnostic threshold compared with 12 subjects (34%) who had an NT-proBNP below the diagnostic threshold (P=0.01). Preoperative NT-proBNP greater than= 3984 ng litre(-1) [odds ratio (OR) 3.0; 95% confidence interval (CI) 1.0-8.9] and congestive heart failure (OR 3.0; 95% CI 1.0-9.0) were independent predictors of perioperative adverse cardiac events. A total of eight subjects (12%) died within 30 days after operation. There is a high incidence of elevated NT-proBNP in subjects undergoing non-elective hip fracture surgery. Preoperative NT-proBNP is a valuable predictor of cardiac complications in the perioperative period.
Place, publisher, year, edition, pages
Oxford University Press, 2009. Vol. 103, no 2, 206-212 p.
complications; morbidity; heart; myocardial function; surgery; non-cardiac; surgery; orthopaedic
IdentifiersURN: urn:nbn:se:liu:diva-20147DOI: 10.1093/bja/aep139ISI: 000268107800009PubMedID: 19525507OAI: oai:DiVA.org:liu-20147DiVA: diva2:233660