Surgery
Conditions
Keywords
natriuretic peptides, emergency non-cardiac surgery
Brief summary
The investigators hypothesize that the level of perioperative natriuretic peptides is associated with in-hospital and long term major adverse cardiac events.
Detailed description
The purpose of the study is to measure levels of brain natriuretic peptides before and after urgent non-cardiac surgery and to evaluate their predictive value for adverse long-term outcome.
Interventions
None listed
Sponsors
Medical University of Graz
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Emergency surgery: 1. Vascular 2. Intra-abdominal 3. Orthopedic
Exclusion criteria
* Patients unable to provide informed consent * Thoracic surgery * Trauma surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurence of Adverse Cardiac Events | postoperatively (index surgery) until a median follow-up of 34 months | Occurence of major adverse cardiac events (composite of nonfatal myocardial infarction, acute heart failure or death). Non-fatal Myocardial infarction was defined as a typical increase and decrease of troponin together with evidence of myocardial ischemia with at least one of the following: symptoms of ischemia, ECG changes indicative of ischemia or new Q waves, or imaging evidence of new regional wall motion abnormality. Acute heart failure was defined as clinical signs and symptoms of heart failure with echocardiographic evidence of cardiac dysfunction and clinical response to treatment directed towards heart failure. |
Other
| Measure | Time frame | Description |
|---|---|---|
| NT-ProBNP Preoperative | 0-24 hours before induction of anesthesia | NT-ProBNP was measured 0-24 hours before induction of anesthesia |
| Association Between Preoperative NT-ProBNP and Occurence of Adverse Cardiac Events | postoperatively (index surgery) until a median follow-up of 34 months | Evaluation of the association between preoperative NT-ProBNP and occurence of adverse cardiac events |
Countries
Austria
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| One Arm consecutive patients presenting for emergent non-cardiac surgery | 297 |
| Total | 297 |
Baseline characteristics
| Characteristic | One Arm |
|---|---|
| Age, Continuous | 74 years |
| Sex: Female, Male Female | 180 Participants |
| Sex: Female, Male Male | 117 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 297 |
| serious Total, serious adverse events | 91 / 297 |
Outcome results
Primary
Occurence of Adverse Cardiac Events
Occurence of major adverse cardiac events (composite of nonfatal myocardial infarction, acute heart failure or death). Non-fatal Myocardial infarction was defined as a typical increase and decrease of troponin together with evidence of myocardial ischemia with at least one of the following: symptoms of ischemia, ECG changes indicative of ischemia or new Q waves, or imaging evidence of new regional wall motion abnormality. Acute heart failure was defined as clinical signs and symptoms of heart failure with echocardiographic evidence of cardiac dysfunction and clinical response to treatment directed towards heart failure.
Time frame: postoperatively (index surgery) until a median follow-up of 34 months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| No Treatment | Occurence of Adverse Cardiac Events | 91 participants |
Other Pre-specified
Association Between Preoperative NT-ProBNP and Occurence of Adverse Cardiac Events
Evaluation of the association between preoperative NT-ProBNP and occurence of adverse cardiac events
Time frame: postoperatively (index surgery) until a median follow-up of 34 months
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| No Treatment | Association Between Preoperative NT-ProBNP and Occurence of Adverse Cardiac Events | 1527 pg/ml |
| Patients Not Sustaining Adverse Events | Association Between Preoperative NT-ProBNP and Occurence of Adverse Cardiac Events | 296 pg/ml |
Other Pre-specified
NT-ProBNP Preoperative
NT-ProBNP was measured 0-24 hours before induction of anesthesia
Time frame: 0-24 hours before induction of anesthesia
Population: Consecutive patients undergoing emergent non-cardiac surgery
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| No Treatment | NT-ProBNP Preoperative | 491 pg/ml |