Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery

Abstract To develop a predictive model based on the perioperative plasma concentration of amino-terminal pro-brain natriuretic peptide (NT-pro BNP) in elderly patients to assess the risk of severe postoperative complications. Elderly patients (age ≥ 65 years) enrolled in this prospective observation...

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Main Authors: Yihao Zhu, Yi Zhao, Tao Zhu, Fei Wang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11760-x
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author Yihao Zhu
Yi Zhao
Tao Zhu
Fei Wang
author_facet Yihao Zhu
Yi Zhao
Tao Zhu
Fei Wang
author_sort Yihao Zhu
collection DOAJ
description Abstract To develop a predictive model based on the perioperative plasma concentration of amino-terminal pro-brain natriuretic peptide (NT-pro BNP) in elderly patients to assess the risk of severe postoperative complications. Elderly patients (age ≥ 65 years) enrolled in this prospective observational study underwent general surgery. Plasma NT-Pro BNP concentration was measured before surgery and 2 h after surgery. Univariate and multivariate logistic regression analyses were used to identify the significant predictors. To evaluate the model performance, we applied the receiver operating characteristic (ROC) curve, Hosmer–Lemeshow test, and decision curve analysis (DCA) to evaluate the net clinical benefit. Prediction model was visualised by drawing nomogram and establishing web calculator. A total of 174 elderly patients were enrolled; 15 patients (8.6%) developed severe complications. The area under the ROC curve, sensitivity, and specificity of the two prediction models were 0.899 (95% CI 0.845–0.940), 86.67%, 91.82%, 0.956 (95% CI 0.902–0.985), 100%, and 81.42%, respectively. The net benefit of the post-model was higher than pre-model. We established two postoperative severe complication assessment models based on perioperative NT-Pro BNP levels for elderly patients with reliable accuracy. The nomogram and web calculator will be easy to use by clinicians and other researchers. Clinical significance: The biomarker, NT-pro BNP seem to correlate with some postoperative complications, however no studies have evaluated its relationship with severe postoperative complications in elderly patients. In this study, we evaluated the relationship between NT-pro BNP and severe postoperative complications in elderly patients, and established a prediction model and a web calculator based on the prediction model. Clinicians can easily use this prediction model to identify high-risk patients at an early stage.
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spelling doaj-art-2ab3680dd5bd4fd4a02f84beb482e95a2025-08-20T04:01:51ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-11760-xPerioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgeryYihao Zhu0Yi Zhao1Tao Zhu2Fei Wang3Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of ChinaDepartment of Anesthesiology, West China Hospital, Sichuan UniversityDepartment of Anesthesiology, West China Hospital, Sichuan UniversityDepartment of Anesthesiology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaAbstract To develop a predictive model based on the perioperative plasma concentration of amino-terminal pro-brain natriuretic peptide (NT-pro BNP) in elderly patients to assess the risk of severe postoperative complications. Elderly patients (age ≥ 65 years) enrolled in this prospective observational study underwent general surgery. Plasma NT-Pro BNP concentration was measured before surgery and 2 h after surgery. Univariate and multivariate logistic regression analyses were used to identify the significant predictors. To evaluate the model performance, we applied the receiver operating characteristic (ROC) curve, Hosmer–Lemeshow test, and decision curve analysis (DCA) to evaluate the net clinical benefit. Prediction model was visualised by drawing nomogram and establishing web calculator. A total of 174 elderly patients were enrolled; 15 patients (8.6%) developed severe complications. The area under the ROC curve, sensitivity, and specificity of the two prediction models were 0.899 (95% CI 0.845–0.940), 86.67%, 91.82%, 0.956 (95% CI 0.902–0.985), 100%, and 81.42%, respectively. The net benefit of the post-model was higher than pre-model. We established two postoperative severe complication assessment models based on perioperative NT-Pro BNP levels for elderly patients with reliable accuracy. The nomogram and web calculator will be easy to use by clinicians and other researchers. Clinical significance: The biomarker, NT-pro BNP seem to correlate with some postoperative complications, however no studies have evaluated its relationship with severe postoperative complications in elderly patients. In this study, we evaluated the relationship between NT-pro BNP and severe postoperative complications in elderly patients, and established a prediction model and a web calculator based on the prediction model. Clinicians can easily use this prediction model to identify high-risk patients at an early stage.https://doi.org/10.1038/s41598-025-11760-xAmino-terminal pro-brain natriuretic peptideElderly patientsNomogramPostoperative complicationsPrediction modelWeb calculator
spellingShingle Yihao Zhu
Yi Zhao
Tao Zhu
Fei Wang
Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
Scientific Reports
Amino-terminal pro-brain natriuretic peptide
Elderly patients
Nomogram
Postoperative complications
Prediction model
Web calculator
title Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
title_full Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
title_fullStr Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
title_full_unstemmed Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
title_short Perioperative NT pro BNP can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
title_sort perioperative nt pro bnp can predict severe postoperative complications in elderly patients undergoing noncardiac surgery
topic Amino-terminal pro-brain natriuretic peptide
Elderly patients
Nomogram
Postoperative complications
Prediction model
Web calculator
url https://doi.org/10.1038/s41598-025-11760-x
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AT yizhao perioperativentprobnpcanpredictseverepostoperativecomplicationsinelderlypatientsundergoingnoncardiacsurgery
AT taozhu perioperativentprobnpcanpredictseverepostoperativecomplicationsinelderlypatientsundergoingnoncardiacsurgery
AT feiwang perioperativentprobnpcanpredictseverepostoperativecomplicationsinelderlypatientsundergoingnoncardiacsurgery