title: Postoperative B-type natriuretic Peptide levels associated with prolonged hospitalization in hypertensive patients after non-cardiac surgery.
abstract: OBJECTIVE
  B-type natriuretic peptide (BNP) is an important marker for the diagnosis of heart failure and is useful towards predicting morbidity and mortality after non-cardiac surgery. Nevertheless, information on the relationship between postoperative BNP levels and perioperative prognosis after non-cardiac surgery is scarce. The purpose of the study was to assess whether postoperative BNP levels could be used as a predictor of prolonged hospitalization in elderly hypertensive patients after non-cardiac surgery.
  
  
  METHODS
  Ninety-seven (97) patients, aged 55 years or older (mean age: 73.12±10.05 years, M : F=24 : 73) were enrolled in a prospective study from May 2005 through August 2010. All patients underwent total knee or hip replacement. Postoperative BNP and other diagnostic data were recorded within 24 hours of surgery. Patients that required a prolonged hospital stay due to operative causes, such as wound infection and re-operation, were excluded.
  
  
  RESULTS
  The length of hospital stay was significantly correlated with postoperative BNP levels (p=0.031). Receiver operating characteristic curves demonstrated postoperative BNP levels as predictors of hospital stay ≥30 days with areas under the curve of 0.774 (95% confidence interval: 0.679-0.87, p<0.0001). A BNP cut-off value above 217.5 pg/mL had a sensitivity of 80.6% and a specificity of 66.7% for predicting postoperative hospital stays of 30 days or more.
  
  
  CONCLUSIONS
  Postoperative BNP levels may predict the length of hospital stays after non-cardiac surgery in hypertensive patients. Elevated BNP levels were associated with prolonged hospitalization after elective orthopedic surgery.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kang Nam General Hosptial, Yongin, Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Park
authors.forename: Gil Ja
authors.initials: GJ
authors.lastname: Shin
authors.forename: Jae In
authors.initials: JI
authors.lastname: Ryu
authors.forename: Wook Bum
authors.initials: WB
authors.lastname: Pyun