Relationship between Perioperative N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Complications in Thoracic Surgery

Background: In cardiac surgery, the N-terminal pro-brain natriuretic peptide (NT-proBNP) level is reportedly correlated with the onset of postoperative complications. We examined the relationship between the NT-proBNP level and perioperative complications in thoracic surgery and elucidated the significance of NT-proBNP measurement. Methods: We evaluated 48 patients excluding hemodialysis patients who underwent lung resection from November 2015 to February 2016. NT-proBNP measurement was performed three times preoperatively on postoperative days 2 and 5. We examined the relationship between clinical background factors such as preoperative comorbidity and the development of postoperative complications. Based on established criteria for surgical complications (Clavien-Dindo classification), grade ≥ II was defined as a complications. We classified the patients into two groups (with or without complications) and compared and examined the background factors between the groups. Results: The study included 48 patients (33 male, 15 female) with an average age of 72 years (range, 35 - 86 years). Preoperative comorbidities included cardiovascular disease in five patients, diabetes mellitus in four, and chronic obstructive pulmonary disease in six. The average operation time was 163 (29 - 308) minutes, and the bleeding volume was 30 (10 - 620) ml. Early complications were confirmed in 11 patients, and late complications were confirmed in 7 patients. A high NT-proBNP level on postoperative day 5 was an independent risk factor for late complications. Conclusion: The perioperative NT-proBNP level is considered to be a predictor of complications. Its measurement is useful for predicting postoperative complications, and careful perioperative management is required for patients with high levels.