Impact of preoperative brain natriuretic peptide level for predicting postoperative respiratory complications.

Background: Predicting respiratory complications after pulmonary surgery is important for thoracic surgeons. This study aimed to clarify the relationship between preoperative brain natriuretic peptide (BNP) levels and postoperative respiratory complications (PRC).

Methods: A total of 383 patients with primary or metastatic lung cancer who underwent surgical resection were included in this retrospective study. The cut-off value of elevated BNP was set as 35 pg/mL, and its relationship with PRCs was analyzed. Risk factors for PRCs were determined using a logistic regression model.

Results: Among the patients, 66 (17%) experienced PRCs: 24% vs. 14% with BNP levels ≥35 and <35 pg/mL, respectively (P=0.02). In patients with a BNP level ≥35 pg/mL, the development of PRCs was higher in those who underwent lobectomy (34%) than in those who underwent sublobar resection (14%) (P=0.01). Univariate [odds ratio (OR): 1.947, 95% confidence interval (CI): 1.13-3.352, P=0.02] and multivariate (OR: 1.838, 95% CI: 1.032-3.273, P=0.04) analyses revealed a significant association between a preoperative BNP level ≥35 pg/mL and a higher risk of PRCs in all patients.

Conclusions: Preoperative BNP levels ≥35 pg/mL were associated with an increased risk for PRCs, suggesting its potential utility for identifying patients with elevated risk for PRCs before pulmonary surgery.