A prospective, multi-centre, observational study of preoperative natriuretic peptide testing for patients undergoing non-cardiac surgery conducted over four weeks.
Identification of high-risk surgical patients requires risk stratification. Current clinical risk stratification tools, e.g. Revised Cardiac Risk Index (RCRI), only have a moderate ability to identify these patients. International guidelines, like Canadian Cardiovascular Society on perioperative cardiovascular risk assessment, advocate that all patients 45 yrs and older or patients \>18y rs who have significant cardiovascular disease and who are coming for intermediate to high-risk surgery, should get natriuretic peptide (NP) testing. This is because raised preoperative B-type natriuretic peptides have a strong association with postoperative cardiac complications according to observational studies and meta-analyses. However, in these patients with significant cardiovascular disease coming for intermediate to high-risk surgery it is unknown how many patients will actually have raised B-type natriuretic peptides. That is, which group of patients have an even higher risk in this already high-risk group. Natriuretic peptide (NP) testing is also expensive. Further identification of patients that need NP testing will reduce costs and focus efforts on those patients who really need it.
Study Type
OBSERVATIONAL
Enrollment
174
Groote Schuur Hospital
Cape Town, Western Cape, South Africa
Raised natriuretic peptide
Determine the prevalence of abnormal (raised) NP in patients with clinical risk criteria.
Time frame: preoperative
Risk prediction
The secondary objective is to develop a risk prediction model for those patients who will need preoperative NP screening.
Time frame: preoperative
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