NT-proBNP to improve risk stratification in orthopaedic surgery
Research type
Research Study
Full title
The use of NT-proBNP measurements in the preoperative setting: can it be of benefit for patients undergoing elective knee and hip arthroplasty?
IRAS ID
240793
Contact name
Simon J Howell
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
0 years, 2 months, 7 days
Research summary
This observational cohort study seeks to investigate the value in measuring a cardiac biomarker called N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in the preoperative assessment of elective knee and hip surgical patients. This biomarker is released in response to excess stress upon the heart and was first used within heart failure patients. In 2017, the Canadian Cardiovascular Society (CCS) made strong recommendations that the measurement of NT-proBNP should be used in surgical patients with or at risk of cardiac disease to improve cardiac risk prediction. Identification of high-risk patients ensures that critical care and high dependency facilities are directed towards those at risk of complications. A blood test that can efficiently assess patients prior to surgery may improve outcomes, save trust money and improve efficiencies with regard to clinician’s time.
Several studie support the use of NT-proBNP measurements in the preoperative assessment of patients to predict surgical outcomes. We wish to assess this test as a simple adjunct in helping clinician’s direct patients for further preoperative assessment prior to orthopaedic surgery. However, there is no current protocol followed at LTHT for ordering this blood test and is only done at the clinicians discretion.
The study will include patients over the age of 65, due to undergo elective knee or hip surgery. Viable patients will be identified within preoperative assessment by the consultant overseeing their care. Consenting participants will have an additional blood test carried out at the same time that blood is collected for the usual preoperative blood tests by a health care professional. Observational data on postoperative outcome are routinely collected in this orthopaedic service and the association between these outcomes and NT-proBNP concentration will be analysed following surgery. This single centre observational study aims to recruit 100 participants.
REC name
London - London Bridge Research Ethics Committee
REC reference
18/LO/0386
Date of REC Opinion
19 Mar 2018
REC opinion
Favourable Opinion