title: B-type natriuretic Peptide as a predictor of postoperative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Postoperative 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.
  
  
  CONCLUSIONS
  Preoperative B-type natriuretic peptide level could be a useful predictor of postoperative cardiopulmonary complications in elderly patients after pulmonary resection for lung cancer.
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Nojiri
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeda
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Funakoshi
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007124:Immunoenzyme Techniques; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011013:Pneumonectomy / Q000009:adverse effects*; D011014:Pneumonia / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects
chemical_list: D020097:Natriuretic Peptide, Brain