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EuroSCORE II and N-...
EuroSCORE II and N-terminal pro-B-type natriuretic peptide for risk evaluation : an observational longitudinal study in patients undergoing coronary artery bypass graft surgery
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- Holm, Jonas (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
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- Vidlund, Mårten, 1968- (författare)
- Örebro universitet,Institutionen för hälsovetenskap och medicin,Department of Cardiothoracic Surgery and Anaesthesia, Örebro University Hospital, Örebro, Sweden
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- Vánky, Farkas (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
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- Friberg, Örjan (författare)
- Department of Cardiothoracic Surgery and Anaesthesia, Örebro University Hospital, Örebro, Sweden
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- Håkanson, E. (författare)
- Östergötlands Läns Landsting,Thorax-kärlkliniken i Östergötland
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- Walther, Sten (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
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- Svedjeholm, Rolf (författare)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Thorax-kärlkliniken i Östergötland
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(creator_code:org_t)
- Oxford University Press, 2014
- 2014
- Engelska.
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Ingår i: British Journal of Anaesthesia. - : Oxford University Press. - 0007-0912 .- 1471-6771. ; 113:1, s. 75-82
- Relaterad länk:
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http://bjanaesthesia...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Background: Postoperative heart failure remains the major cause of death after cardiac surgery. As N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a predictor for postoperative heart failure, the aim was to evaluate if preoperative NT-proBNP could provide additional prognostic information to the recently launched EuroSCORE II.Methods: A total of 365 patients with acute coronary syndrome (ACS) undergoing isolated coronary artery bypass graft (CABG) surgery were studied prospectively. Preoperative NT-proBNP and EuroSCORE II were evaluated with regard to severe circulatory failure after operation according to prespecified criteria. To assess what clinical outcomes are indicated by NT-proBNP levels in different risk categories, the patients were stratified according to EuroSCORE II. Based on receiver operating characteristics analysis, these cohorts were assessed with regard to preoperative NT-proBNP below or above 1028 ng litre(-1). The follow-up time averaged 4.4 (0.7) yr.Results: Preoperative NT-proBNP >= 1028 ng litre(-1) [odds ratio (OR) 9.9,95% confidence interval (CI) 1.01-98.9; P=0.049] and EuroSCORE II (OR 1.24, 95% CI 1.06-1.46; P=0.008) independently predicted severe circulatory failure after operation. In intermediate-risk patients (EuroSCORE II 2.0-10.0), NT-proBNP >= 1028 ng litre(-1) was associated with a higher incidence of severe circulatory failure (6.6% vs 0%; P=0.007), renal failure (14.8% vs 5.4%; P=0.03), stroke (6.6% vs 0.7%; P=0.03), longer intensive care unit stay [37 (35) vs 27 (38) h; P=0.002], and worse long-term survival.Conclusions: Combining EuroSCORE II and preoperative NT-proBNP appears to improve risk prediction with regard to severe circulatory failure after isolated CABG for ACS. NT-proBNP may be particularly useful in patients at intermediate risk according to EuroSCORE II.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Nyckelord
- acute coronary syndrome
- coronary artery bypass surgery
- natriuretic peptides
- risk assessment
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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