کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3239655 1206015 2012 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Preoperative plasma B-type natriuretic peptide (BNP) identifies abnormal transthoracic echocardiography in elderly patients with traumatic hip fracture
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی طب اورژانس
پیش نمایش صفحه اول مقاله
Preoperative plasma B-type natriuretic peptide (BNP) identifies abnormal transthoracic echocardiography in elderly patients with traumatic hip fracture
چکیده انگلیسی

IntroductionThis prospective study was designed to evaluate whether preoperative plasma brain natriuretic peptide (BNP) could identify significant preoperative cardiovascular disease in elderly hip-fractured patients.Patients and methodsPreoperative plasma BNP measurement and rest transthoracic echocardiography (TTE) were performed within 24 h after admission in consecutive hip-fractured patients aged ≥65 years. The major echocardiographic abnormality (MEA) group included patients with at least one TTE abnormality, defined as systolic pulmonary artery pressure (PAPs) ≥50 mmHg, left ventricular (LV) systolic dysfunction, increased LV filling pressure (LVFP) or severe valvular disease. The control group included the remaining patients.ResultsSeventy-five patients (mean ± SD (range) age = 85 ± 5 (69–97) years) were included during a 6-month period. Twenty-four (32%) patients constituted the MEA group (17 elevated PAPs, three LV systolic dysfunctions, 10 increased LVFP, one severe aortic stenosis and one severe mitral regurgitation). Median (interquartile) preoperative BNP value was significantly greater in MEA than in the control group (527 (361) vs. 119 (154) pg ml−1; p < 0.0001). A preoperative plasma BNP cut-off value at 285 pg ml−1 predicted well MEA with an area under the receiver operating characteristic (ROC) curve equal to 0.895 (p < 0.0001) and with a hazard ratio (HR) (confidence interval, CI) of 23.8 (3.7–142.9) (p = 0.0008) on multivariate analysis. The presence of MEA or BNP ≥ 285 pg ml−1 was associated with high mortality.DiscussionThe incidence of echocardiographic signs of elevated PAPs or elevated LVFP in elderly hip-fractured patients was high. A preoperative BNP value ≥285 pg ml−1 can discriminate between elderly hip-fractured patients with or without MEA.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Injury - Volume 43, Issue 6, June 2012, Pages 811–816
نویسندگان
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