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https://hdl.handle.net/2440/93763
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Type: | Journal article |
Title: | B-type natriuretic peptide vs. cardiac risk scores for prediction of outcome following major orthopedic surgery |
Author: | Katsanos, S. Babalis, D. Kafkas, N. Mavrogenis, A. Leong, D. Parissis, J. Varounis, C. Makris, K. van der Heijden, A. Anastasiou-Nana, M. Filippatos, G. |
Citation: | Journal of Cardiovascular Medicine, 2015; 16(6):465-471 |
Publisher: | Lippincott Williams and Wilkins |
Issue Date: | 2015 |
ISSN: | 1558-2027 1558-2035 |
Statement of Responsibility: | Spyridon Katsanos, Dimitrios Babalis, Nikolaos Kafkas, Andreas Mavrogenis, Darryl Leong, John Parissis, Christos Varounis, Konstantinos Makris, Asfke van der Heijden, Maria Anastasiou-Nana, Gerasimos Filippatos |
Abstract: | Aims: The clinical role of B-type natriuretic peptide (BNP) in preoperative evaluation is not clear. We designed a prospective study to investigate the predictive value of BNP in comparison with established clinical risk scores for the outcome of major orthopedic surgery. Methods: Overall 242 elderly patients [80 (74-85) years] undergoing orthopedic surgery were included. Inhospital cardiovascular events and 1-year mortality were the main endpoints. Results: In total 20 (8.3%) patients had major cardiovascular events (MACE) and 41 (21.1%) died in 1 year. Logistic regression analysis for prediction of cardiac events and 1-year mortality, respectively, revealed a significant prognostic value for the BNP (P < 0.001 and P = 0.041), Goldman (P = 0.013 and P = 0.003), Lee (P = 0.022 and P = 0.200), Detsky (P < 0.001 and P < 0.001), and functional capacity indices (P = 0.034 and P = 0.001). BNP cutoff 149 ng/ml improved discrimination of all scores to predict MACE, and BNP cutoff 89 ng/ml improved discrimination of all scores to predict 1-year mortality (Net Reclassification Improvement, P values < 0.05 in all cases). Age [hazard ratio (HR): 1.100, 95% confidence interval (CI): 1.039-1.166, P = 0.001] and BNP (HR: 1.002, 95% CI: 1.000-1.003, P = 0.041) were independent associates of 1-year mortality. Conclusion: Preoperative levels of BNP compare favorably with the Goldman, Lee, Detsky, and functional capacity indices for prognosis of orthopedic surgery. Implementation of natriuretic peptides in cardiac risk scores is promising. |
Keywords: | B-type natriuretic peptide; orthopedic; risk score |
Rights: | © 2015 Wolters Kluwer Health, Inc. All rights reserved. |
DOI: | 10.2459/JCM.0000000000000210 |
Published version: | http://dx.doi.org/10.2459/jcm.0000000000000210 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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