B-Type Natriuretic Peptide as a Predictor of Postoperative Cardiopulmonary Complications in Elderly Patients Undergoing Pulmonary Resection for Lung Cancer

Background The objective of the present study was to evaluate the utility of B-type natriuretic peptide for prediction of postoperative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer. Methods A prospective observational study was performed involving...

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Veröffentlicht in:The Annals of thoracic surgery 2011-09, Vol.92 (3), p.1051-1055
Hauptverfasser: Nojiri, Takashi, MD, Inoue, Masayoshi, MD, PhD, Yamamoto, Kazuhiro, MD, PhD, Maeda, Hajime, MD, PhD, Takeuchi, Yukiyasu, MD, PhD, Funakoshi, Yasunobu, MD, PhD, Okumura, Meinoshin, MD, PhD
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container_issue 3
container_start_page 1051
container_title The Annals of thoracic surgery
container_volume 92
creator Nojiri, Takashi, MD
Inoue, Masayoshi, MD, PhD
Yamamoto, Kazuhiro, MD, PhD
Maeda, Hajime, MD, PhD
Takeuchi, Yukiyasu, MD, PhD
Funakoshi, Yasunobu, MD, PhD
Okumura, Meinoshin, MD, PhD
description Background The objective of the present study was to evaluate the utility of B-type natriuretic peptide for prediction of postoperative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer. Methods A prospective observational study was performed involving 80 consecutive patients aged 75 years or older who underwent a scheduled pulmonary resection for lung cancer in two specialized thoracic centers between January 2008 and June 2010. Baseline clinical details were obtained, and spirometry and examination of serum B-type natriuretic peptide levels were performed before surgery. The primary endpoint was the incidence of postoperative cardiopulmonary complications. Results Postoperative cardiopulmonary complications were identified in 34 (43%) patients; these patients had significantly higher preoperative B-type natriuretic peptide levels than those without cardiopulmonary complications (84.0 ± 93.7 pg/mL vs 22.0 ± 18.2 pg/mL; p < 0.0001). The area under the receiver operating characteristic curve for B-type natriuretic peptide to predict postoperative cardiopulmonary complications after pulmonary resection for lung cancer was 0.85 (95% confidence interval 0.76 to 0.94; p < 0.0001). A B-type natriuretic peptide value of 30 pg/mL had a sensitivity of 79% and a specificity of 83% for predicting postoperative cardiopulmonary complications after pulmonary resection for lung cancer. The incidences of both cardiovascular and respiratory complications were significantly higher in patients with preoperative B-type natriuretic peptide levels of 30 pg/mL or more. Conclusions Preoperative B-type natriuretic peptide level could be a useful predictor of postoperative cardiopulmonary complications in elderly patients after pulmonary resection for lung cancer.
doi_str_mv 10.1016/j.athoracsur.2011.03.085
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Methods A prospective observational study was performed involving 80 consecutive patients aged 75 years or older who underwent a scheduled pulmonary resection for lung cancer in two specialized thoracic centers between January 2008 and June 2010. Baseline clinical details were obtained, and spirometry and examination of serum B-type natriuretic peptide levels were performed before surgery. The primary endpoint was the incidence of postoperative cardiopulmonary complications. Results Postoperative cardiopulmonary complications were identified in 34 (43%) patients; these patients had significantly higher preoperative B-type natriuretic peptide levels than those without cardiopulmonary complications (84.0 ± 93.7 pg/mL vs 22.0 ± 18.2 pg/mL; p &lt; 0.0001). The area under the receiver operating characteristic curve for B-type natriuretic peptide to predict postoperative cardiopulmonary complications after pulmonary resection for lung cancer was 0.85 (95% confidence interval 0.76 to 0.94; p &lt; 0.0001). A B-type natriuretic peptide value of 30 pg/mL had a sensitivity of 79% and a specificity of 83% for predicting postoperative cardiopulmonary complications after pulmonary resection for lung cancer. The incidences of both cardiovascular and respiratory complications were significantly higher in patients with preoperative B-type natriuretic peptide levels of 30 pg/mL or more. Conclusions Preoperative B-type natriuretic peptide level could be a useful predictor of postoperative cardiopulmonary complications in elderly patients after pulmonary resection for lung cancer.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2011.03.085</identifier><identifier>PMID: 21871299</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Female ; Follow-Up Studies ; Heart Diseases - blood ; Heart Diseases - epidemiology ; Heart Diseases - etiology ; Humans ; Immunoenzyme Techniques ; Incidence ; Japan - epidemiology ; Lung Neoplasms - surgery ; Male ; Medical sciences ; Natriuretic Peptide, Brain - blood ; Pneumology ; Pneumonectomy - adverse effects ; Pneumonia - blood ; Pneumonia - epidemiology ; Pneumonia - etiology ; Prognosis ; Prospective Studies ; Respiratory Distress Syndrome, Adult - blood ; Respiratory Distress Syndrome, Adult - epidemiology ; Respiratory Distress Syndrome, Adult - etiology ; Risk Factors ; ROC Curve ; Surgery ; Survival Rate - trends ; Thoracic Surgery, Video-Assisted - adverse effects ; Tumors of the respiratory system and mediastinum</subject><ispartof>The Annals of thoracic surgery, 2011-09, Vol.92 (3), p.1051-1055</ispartof><rights>The Society of Thoracic Surgeons</rights><rights>2011 The Society of Thoracic Surgeons</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 The Society of Thoracic Surgeons. 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Methods A prospective observational study was performed involving 80 consecutive patients aged 75 years or older who underwent a scheduled pulmonary resection for lung cancer in two specialized thoracic centers between January 2008 and June 2010. Baseline clinical details were obtained, and spirometry and examination of serum B-type natriuretic peptide levels were performed before surgery. The primary endpoint was the incidence of postoperative cardiopulmonary complications. Results Postoperative cardiopulmonary complications were identified in 34 (43%) patients; these patients had significantly higher preoperative B-type natriuretic peptide levels than those without cardiopulmonary complications (84.0 ± 93.7 pg/mL vs 22.0 ± 18.2 pg/mL; p &lt; 0.0001). The area under the receiver operating characteristic curve for B-type natriuretic peptide to predict postoperative cardiopulmonary complications after pulmonary resection for lung cancer was 0.85 (95% confidence interval 0.76 to 0.94; p &lt; 0.0001). A B-type natriuretic peptide value of 30 pg/mL had a sensitivity of 79% and a specificity of 83% for predicting postoperative cardiopulmonary complications after pulmonary resection for lung cancer. The incidences of both cardiovascular and respiratory complications were significantly higher in patients with preoperative B-type natriuretic peptide levels of 30 pg/mL or more. Conclusions Preoperative B-type natriuretic peptide level could be a useful predictor of postoperative cardiopulmonary complications in elderly patients after pulmonary resection for lung cancer.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Diseases - blood</topic><topic>Heart Diseases - epidemiology</topic><topic>Heart Diseases - etiology</topic><topic>Humans</topic><topic>Immunoenzyme Techniques</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Pneumology</topic><topic>Pneumonectomy - adverse effects</topic><topic>Pneumonia - blood</topic><topic>Pneumonia - epidemiology</topic><topic>Pneumonia - etiology</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Respiratory Distress Syndrome, Adult - blood</topic><topic>Respiratory Distress Syndrome, Adult - epidemiology</topic><topic>Respiratory Distress Syndrome, Adult - etiology</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Surgery</topic><topic>Survival Rate - trends</topic><topic>Thoracic Surgery, Video-Assisted - adverse effects</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nojiri, Takashi, MD</creatorcontrib><creatorcontrib>Inoue, Masayoshi, MD, PhD</creatorcontrib><creatorcontrib>Yamamoto, Kazuhiro, MD, PhD</creatorcontrib><creatorcontrib>Maeda, Hajime, MD, PhD</creatorcontrib><creatorcontrib>Takeuchi, Yukiyasu, MD, PhD</creatorcontrib><creatorcontrib>Funakoshi, Yasunobu, MD, PhD</creatorcontrib><creatorcontrib>Okumura, Meinoshin, MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nojiri, Takashi, MD</au><au>Inoue, Masayoshi, MD, PhD</au><au>Yamamoto, Kazuhiro, MD, PhD</au><au>Maeda, Hajime, MD, PhD</au><au>Takeuchi, Yukiyasu, MD, PhD</au><au>Funakoshi, Yasunobu, MD, PhD</au><au>Okumura, Meinoshin, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>B-Type Natriuretic Peptide as a Predictor of Postoperative Cardiopulmonary Complications in Elderly Patients Undergoing Pulmonary Resection for Lung Cancer</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2011-09-01</date><risdate>2011</risdate><volume>92</volume><issue>3</issue><spage>1051</spage><epage>1055</epage><pages>1051-1055</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background The objective of the present study was to evaluate the utility of B-type natriuretic peptide for prediction of postoperative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer. Methods A prospective observational study was performed involving 80 consecutive patients aged 75 years or older who underwent a scheduled pulmonary resection for lung cancer in two specialized thoracic centers between January 2008 and June 2010. Baseline clinical details were obtained, and spirometry and examination of serum B-type natriuretic peptide levels were performed before surgery. The primary endpoint was the incidence of postoperative cardiopulmonary complications. Results Postoperative cardiopulmonary complications were identified in 34 (43%) patients; these patients had significantly higher preoperative B-type natriuretic peptide levels than those without cardiopulmonary complications (84.0 ± 93.7 pg/mL vs 22.0 ± 18.2 pg/mL; p &lt; 0.0001). The area under the receiver operating characteristic curve for B-type natriuretic peptide to predict postoperative cardiopulmonary complications after pulmonary resection for lung cancer was 0.85 (95% confidence interval 0.76 to 0.94; p &lt; 0.0001). A B-type natriuretic peptide value of 30 pg/mL had a sensitivity of 79% and a specificity of 83% for predicting postoperative cardiopulmonary complications after pulmonary resection for lung cancer. The incidences of both cardiovascular and respiratory complications were significantly higher in patients with preoperative B-type natriuretic peptide levels of 30 pg/mL or more. Conclusions Preoperative B-type natriuretic peptide level could be a useful predictor of postoperative cardiopulmonary complications in elderly patients after pulmonary resection for lung cancer.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21871299</pmid><doi>10.1016/j.athoracsur.2011.03.085</doi><tpages>5</tpages></addata></record>
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subjects Age Factors
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiology. Vascular system
Cardiothoracic Surgery
Female
Follow-Up Studies
Heart Diseases - blood
Heart Diseases - epidemiology
Heart Diseases - etiology
Humans
Immunoenzyme Techniques
Incidence
Japan - epidemiology
Lung Neoplasms - surgery
Male
Medical sciences
Natriuretic Peptide, Brain - blood
Pneumology
Pneumonectomy - adverse effects
Pneumonia - blood
Pneumonia - epidemiology
Pneumonia - etiology
Prognosis
Prospective Studies
Respiratory Distress Syndrome, Adult - blood
Respiratory Distress Syndrome, Adult - epidemiology
Respiratory Distress Syndrome, Adult - etiology
Risk Factors
ROC Curve
Surgery
Survival Rate - trends
Thoracic Surgery, Video-Assisted - adverse effects
Tumors of the respiratory system and mediastinum
title B-Type Natriuretic Peptide as a Predictor of Postoperative Cardiopulmonary Complications in Elderly Patients Undergoing Pulmonary Resection for Lung Cancer
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