Comparison of preoperative NT-proBNP and simple cardiac risk scores for predicting postoperative morbidity after non-cardiac surgery with intermediate or high surgical risk

• Published in: Perioperative medicine (London) 2024-05, Vol.13 (1), p.44-44, Article 44
• Main Authors: Schmidt, Götz, Frieling, Nora, Schneck, Emmanuel, Habicher, Marit, Koch, Christian, Aßmus, Birgit, Sander, Michael
• Format: Article
• Language: English
• Subjects: Acute kidney injury; AUB-HAS2; Brain natriuretic peptide; Cardiac patients; Cardiovascular diseases; Comparative analysis; Health aspects; Medical research; Medicine, Experimental; Morbidity; Natriuretic peptides; Perioperative; Rehospitalisation; Revised cardiac risk index; Risk factors
• ISSN: 2047-0525; 2047-0525
• DOI: 10.1186/s13741-024-00400-z

Chronic heart failure (HF) is frequent in elderly patients undergoing non-cardiac surgery. Preoperative risk stratification is vital and can be achieved using simple clinical risk scores or preoperative N-terminal prohormone of brain natriuretic peptide (NT-proBNP) measurement. This study aimed to compare the predictivity of the revised cardiac risk index (RCRI), the American University of Beirut cardiovascular risk index (AUB-HAS2), and a score proposed by Andersson et al. for postoperative 30-day morbidity to preoperative NT-proBNP. Preoperative NT-proBNP was measured in 199 consecutive patients aged ≥ 65 years undergoing elective non-cardiac surgery with intermediate or high surgical risk. The areas under the receiver operating characteristic curve (AUCROC) for the composite morbidity endpoint (CME) comprising the incidence of any rehospitalisation, acute decompensated HF, acute kidney injury, and any infection at postoperative day 30 were assessed. Multivariable logistic regression analysis derived new scores from the simple risk scores and the NT-proBNP cut-off of 450 pg/mL. AUB-HAS2, but not RCRI or Andersson score, significantly predicted the CME (AUB-HAS2: AUCROC 0.646, p