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

摘要

Study Design and PopulationSurgical ProcedurePreoperative ExaminationsPostoperative ComplicationsStatistical AnalysisResultsThe 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.MethodsA 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.ResultsPostoperative 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.ConclusionsPreoperative B-type natriuretic peptide level could be a useful predictor of postoperative cardiopulmonary complications in elderly patients after pulmonary resection for lung cancer.CTSNet classification:10Lung cancer is generally a disease of older adults, and age has been shown to be an important risk factor for morbidity and mortality after pulmonary resection [