Preoperative B-type Natriuretic Peptide as a Predictor of Postoperative Cardiac Events Following Orthopedic Elderly Patients
Journal of the Korean Geriatrics Society
;
: 184-191, 2012.
Article
in Korean
| WPRIM
| ID: wpr-146674
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate the value of preoperative plasma B-type natriuretic peptide (BNP) level in predicting postoperative in-hospital major adverse cardiac events (MACE, defined as atrial fibrillation, congestive heart failure, nonfatal myocardial infarction and cardiac death) in elderly patients undergoing orthopedic surgery.METHODS:
Between March 2010 and September 2011, data from 156 patients (aged 65 years or older) who underwent scheduled or emergent orthopedic surgery, were investigated. Screening for postoperative in-hospital MACE was performed using clinical criteria.RESULTS:
MACE occurred in 12 patients (7.7%). The BNP level was significantly higher in patients with MACE than in those without (median, 152.0; interquartile range [36.3 to 352.8] pg/mL vs. median, 36.8; interquartile range [15.5 to 98.1] pg/mL, p=0.005). The BNP level was positively correlated with the revised cardiac risk index score (r=0.300, p=0.001). In a receiver operating characteristic (ROC) analysis for MACE, the ROC for BNP was 0.746 (95% confidence interval, 0.602 to 0.891). At the optimal cut-off point (BNP=110 pg/mL), the sensitivity, specificity and positive and negative predictive values were 66.7, 81.2, 22.0% and 96.6%, respectively. On multivariate analysis, preoperative BNP was an independent predictor for MACE (odds ratio, 5.091; p=0.018) after adjusting for baseline confounding factors such as diabetes mellitus and history of cerebrovascular accident.CONCLUSION:
The preoperative BNP level may be a useful tool in stratifying the risk for MACE in elderly patients undergoing orthopedic surgery.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Orthopedics
/
Plasma
/
Atrial Fibrillation
/
Mass Screening
/
Multivariate Analysis
/
ROC Curve
/
Sensitivity and Specificity
/
Natriuretic Peptide, Brain
/
Diabetes Mellitus
/
Heart Failure
Type of study:
Diagnostic study
/
Prognostic study
/
Screening study
Limits:
Aged
/
Humans
Language:
Korean
Journal:
Journal of the Korean Geriatrics Society
Year:
2012
Type:
Article
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