Plasma BNP level combined with surgical Apgar score to predict operative major cardiac adverse events in malignant obstructive jaundice patients

Abstract

Objective:To investigate the predictive effect of major adverse cardiac events (MACE) in malignant obstructive jaundice (OJ) patients using plasma brain natriuretic peptide (BNP) level and surgical Apgar scoring (SAS) system.Methods:Forty one malignant OJ patients undergoing surgical treatments were studied at a single center. Pre-and postoperative plasma BNP level, total bilirubin (TBil) and data of cardiac function (HR, CVP, CI, LVEF%) were detected, the SAS was calculated during the surgery, the relationship of both plasma BNP level and SAS with MACE after surgery was analyzed.Results:Thirteen patients out of 41 (31.71%) experienced MACE without cardiac death. OJ patients had a higher plasma BNP level than baseline before operation (191.61±105.76 pg/ml VS 175 pg/ml, P<0.05), the cardiac function data was improved (CVP: t=4.761, p=0.000; CI: t=3.539, p=0.001; LVEF%: t=3.632, p=0.001) after the operation. Patients with lower SAS had increasing incidence of MACE after surgery.Conclusion:Malignant OJ patients with higher preoperative BNP level and lower surgical Apgar score were identified at high risk of MACE after surgery.

Ability to predict surgical outcomes by surgical Apgar score: a systematic review

“…SAS may be a valuable biomarker foreseeing oncological results in Colorectal cancer SAS ≤ 6 • Overall survivor • Cancer specific survival • Recurrence-free survival 6 Yoshito Tomimaru [ 22 ] 2018 Retrospective cohort Hepatectomy For Hepatocellular carcinoma 158 SAS can predict the after-surgical complications following hepatectomy for hepatocellular carcinoma SAS ≤ 6 • Pleural effusion and/or ascites • Cardiopulmonary • Bile leakage • Ileus • Intra-abdominal abscess • Liver failure Wound infection 7 Y Toyonaga [ 23 ] 2017 Retrospective cohort Emergency abdominal or cerebral surgery 742 A raised danger of post-surgery acute kidney injury (AKI) and mortality was observed in patients with SIRT and SAS scores SAS < 5 • Post-operative Acute kidney injury • Hospital mortality 8 Julio Urrutia [ 24 ] 2015 Prospective study Major and intermediate spinal surgeries 268 Danger can be stratified using Surgical Apgar Score. It is also able to discriminates patients undergoing spine surgery SAS < 4 • 30-day major complication • Death 9 Takanobu Yamada [ 25 ] 2016 Retrospective cohort Gastrectomy For cancer 190 SAS is helpful in prognosis survivorship after Gastric procedure SAS ≤ 6 • Overall survival 10 Wie Yu [ 26 ] 2016 …”