The influence of clinical risk factors on pre-operative B-type natriuretic peptide risk stratification of vascular surgical patients

被引：30

作者：

Biccard, B. M. ^{[1
]}

Buse, G. A. Lurati ^{[2
]}

Burkhart, C. ^{[2
]}

Cuthbertson, B. H. ^{[3
,4
]}

Filipovic, M. ^{[5
]}

Gibson, S. C. ^{[6
]}

Mahla, E. ^{[7
]}

Leibowitz, D. W. ^{[8
]}

Rodseth, R. N. ^{[1
]}

机构：

[1] Univ Kwazulu Natal, Sch Med, Dept Anaesthesia, Inkosi Albert Luthuli Cent Hosp & Nelson R Mandel, Durban, South Africa

[2] Univ Basel Hosp, Dept Anaesthesia & Intens Care Med, CH-4031 Basel, Switzerland

[3] Sunnybrook Hlth Sci Ctr, Dept Crit Care Med, Toronto, ON M4N 3M5, Canada

[4] Univ Toronto, Toronto, ON, Canada

[5] Kantonsspital, Inst Anasthesiol, St Gallen, Switzerland

[6] Stobhill Hosp, Glasgow, Lanark, Scotland

[7] Univ Klin Anasthesie & Intensivmed, Med Univ Graz, Graz, Austria

[8] Hadassah Hebrew Univ Med Ctr, Jerusalem, Israel

来源：

ANAESTHESIA | 2012年 / 67卷 / 01期

基金：

英国医学研究理事会;

关键词：

POSTOPERATIVE CARDIAC EVENTS; PREDICTIVE ABILITY; TERM MORTALITY; VALIDATION; GUIDELINES; SURGERY; UTILITY;

D O I：

10.1111/j.1365-2044.2011.06958.x

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

The role of the revised cardiac risk index in risk stratification has recently been challenged by studies reporting on the superior predictive ability of pre-operative B-type natriuretic peptides. We found that in 850 vascular surgical patients initially risk stratified using B-type natriuretic peptides, reclassification with the number of revised cardiac risk index risk factors worsened risk stratification (p < 0.05 for > 0, > 2, > 3 and > 4 risk factors, and p = 0.23 for > 1 risk factor). When evaluated with pre-operative B-type natriuretic peptides, none of the revised cardiac risk index risk factors were independent predictors of major adverse cardiac events in vascular patients. The only independent predictor was B-type natriuretic peptide stratification (OR 5.1, 95% CI 1.815 for the intermediate class, and OR 25, 95% CI 8.770 for the high-risk class). The clinical risk factors in the revised cardiac risk index cannot improve a risk stratification model based on B-type natriuretic peptides.

引用

页码：55 / 59

页数：5

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