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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Description

Specialty

Objective

ICD-10