B-type natriuretic peptide predicts long-term survival after major non-cardiac surgery

Payne, C.J., Gibson, S.C., Bryce, G., Jardine, A.G. , Berry, C. and Kingsmore, D.B. (2011) B-type natriuretic peptide predicts long-term survival after major non-cardiac surgery. British Journal of Anaesthesia, 107(2), pp. 144-149. (doi: 10.1093/bja/aer119)

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Publisher's URL: http://dx.doi.org/10.1093/bja/aer119

Abstract

Background. The prediction of long-term survival after surgery is complex. Natriuretic peptides can predict short-term postoperative cardiac morbidity and mortality. This study aims to determine the long-term prognostic significance of preoperative B-type natriuretic peptide (BNP) concentration after major non-cardiac surgery. Methods. We conducted a prospective single-centre observational cohort study in a West of Scotland teaching hospital. Three hundred and forty-five patients undergoing major non-cardiac surgery were included. The primary endpoint was long-term all-cause mortality. Results. Overall survival was 67.8% (234/345), with 27 postoperative deaths (within 42 days) and 84 deaths at subsequent follow-up (median follow-up 953 days). A BNP concentration of >87.5 pg ml(-1) best predicted mortality, and the mean survival of patients with an elevated BNP (>87.5 pg ml(-1)) was 731.9 (95% CI 613.6-850.2) days compared with 1284.6 days [(95% CI 1219.3-1350.0), P<0.001] in patients with a BNP<87.5 pg ml(-1). BNP was an independent predictor of survival. Conclusions. BNP is an independent predictor of long-term survival after major non-cardiac surgery. A simple preoperative blood test can provide predictive information on future risk of death, and potentially has a role in preoperative risk assessment.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Kingsmore, Professor David and Jardine, Professor Alan
Authors: Payne, C.J., Gibson, S.C., Bryce, G., Jardine, A.G., Berry, C., and Kingsmore, D.B.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:British Journal of Anaesthesia
ISSN:0007-0912

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