Perioperative medicine & outcomes
Comparison of preoperative N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and simple cardiac risk scores for predicting postoperative morbidity after non-cardiac surgery with intermediate or high surgical risk
Authors' conclusion
The predictive value of postoperative morbidity varies significantly between the available simple perioperative risk scores and can be enhanced by preoperative NT-proBNP.
Study context
- Population
- Patients aged ≥ 65 years undergoing elective non-cardiac surgery with intermediate or high surgical risk
- Participants
- 199 consecutive patients
- Exposure
- NT-proBNP vs AUB-HAS2
- Outcome
- Composite morbidity endpoint:
- Any rehospitalisation
- Acute decompensated heart failure (HF)
- AKI
- Any infection
- Follow-up
- Postoperative day 30
Methodological detailsprognostic accuracy, consecutive patients, multivariable logistic regression
- Prognostic accuracy
- Consecutive patients
- Multivariable logistic regression
Main finding
As reported in the abstract
Prediction of composite morbidity endpoint (AUC ROC)
| Group | AUC | p |
|---|---|---|
| AUB-HAS2 | 0.646 | p < 0.001 |
| Revised cardiac risk index (RCRI) | 0.560 | p = 0.126 |
| Andersson | 0.487 | p = 0.760 |
| NT-proBNP | 0.679 | p < 0.001 |
AUC
AUB-HAS20.646
Revised cardiac risk index (RCRI)0.560
Andersson0.487
NT-proBNP0.679
p
AUB-HAS2p < 0.001
Revised cardiac risk index (RCRI)p = 0.126
Anderssonp = 0.760
NT-proBNPp < 0.001
- NT-proBNP vs AUB-HAS2: P = 0.334 — comparable
Observational data: associations, not effects.
Further findings
| Outcome | Modified AUB-HAS2 | Modified RCRI | P value |
|---|---|---|---|
| Modified scores adding NT-proBNP (AUC ROC)Modified AUB-HAS2 vs AUB-HAS2 · improved | P < 0.001 | ||
| AUC | 0.703 | 0.679 | |
| p | p < 0.001 | p < 0.001 | |
| Modified scores adding NT-proBNP (AUC ROC)Modified RCRI vs RCRI · improved | P < 0.001 | ||
| Modified scores adding NT-proBNP (AUC ROC)NT-proBNP vs modified RCRI · comparable | P = 0.988 | ||
| Modified scores adding NT-proBNP (AUC ROC)NT-proBNP vs modified AUB-HAS2 · comparable | P = 0.367 |
Individual score components (multivariable analysis)
- NT-proBNP ≥ 450 pg/mL strongest predictor of composite morbidity endpoint (CME)
- P < 0.001
Original publication
Comparison of preoperative NT-proBNP and simple cardiac risk scores for predicting postoperative morbidity after non-cardiac surgery with intermediate or high surgical risk. Perioper Med (Lond). Published 17 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →