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

Abstract

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.

Preoperative B-type natriuretic peptides in patients undergoing noncardiac surgery: a cumulative meta-analysis

“…In total, 24 of the 28 studies 29,[34][35][36][37][38][40][41][42][43][46][47][48][49][50][51][52][53][55][56][57][58][59][60] were prospective observational cohort studies. Of the remaining four studies: …”

“…Of the remaining studies, three reported exclusively on patients undergoing emergency surgery, 38,45,48 and one documented both elective and emergency surgeries that were classified as being high risk. 46 Certain studies investigated outcomes in a specific surgical discipline, including thoracic surgery (4), 36,50,51,54 vascular (7), 29,40,42,44,55,57,59 orthopaedic (5), 45,[47][48][49]60 major abdominal (1), 56 oesophagectomy (1), 41 while the rest documented outcomes following a variety of surgeries performed (10), 34,35,[37][38][39]43,46,52,53,58 including a mix of general, head and neck, gynaecological, orthopaedic, vascular, urological, neurosurgery and thoracic surgery.…”

“…Four of the studies 35,45,47,54 specifically reported that the investigators performing data collection and outcome assessment were not blinded, while in 10 of the studies blinding was not indicated. In one study 53 the investigators collecting the data were blinded to the NP value, while those performing outcome assessment were not.…”

“…We conducted a sensitivity analysis that excluded the three studies where the OR was not primarily reported (one study 53 reported a HR, and two reported RR 51,52 ). This analysis yielded similar results, producing a higher cumulative OR of 6.57.…”

Sleep Apnea in Total Joint Arthroplasty Patients and the Role for Cardiac Biomarkers for Risk Stratification: an Exploration of Feasibility

“…Studies measuring BNPs in patients undergoing noncardiac surgery have investigated the role in the perioperative period for risk prediction or associations with adverse postoperative myocardial events [35][36][37][38][39][40][41][42][43][44], prolonged hospital stay [45] and mortality [24,[46][47] (see Table 4). Most of the studies evaluating BNPs had levels drawn within 2 weeks prior to the day of surgery, typically at one time-point, however recent studies have incorporated perioperative BNP levels (levels drawn preoperatively and up to 5 days following surgery) [36,38,43,[45][46].…”