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Perioperative Serum NT-pro-BNP in a Patient Undergoing Emergency Non-Cardiac Surgery

Description

Farzi et al used the N-terminal pro B-type Natriuretic Peptide (NT pro-BNP) to evaluate patients undergoing emergent non-cardiac surgery. A patient undergoing emergency surgery cannot undergo the usual risk assessment available for elective procedures. The authors are from the Medical University of Graz.


 

Patient selection: adult > 50 years of age undergoing emergency non-cardiac surgery

 

Outcome: myocardial infarction, acute heart failure or death (MACE = major adverse cardiac events)

 

Assay: Elecsys ProBNP, Roche Diagnostics (reference range < 540 ng/L according to Alehagen et al).

 

Time of Test

Value

Relative Risk

Type of Analysis

preoperative

> 725 ng/L

4.8 for MACE at 3 years

univariate

preoperative

> 725 ng/L

1.9

multivariate

preoperative

>= 1740 ng/L

6.9 for MACE during admission

univariate (not on multivariate)

postoperative

>= 1600 ng/L

4 for MACE at 3 years

univariate

 

where:

• ng/L equalds pg/mL

 

A patient with an elevated NT pro-BNP should:

(1) receive optimal perioperative care.

(2) undergo the least invasive procedure possible

(3) undergo medical assessment following recovery from surgery.

 


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Specialty

Objective

ICD-10