CORR Insights®: Gunshot Trauma Patients Have Higher Risk of PTSD Compared With Blunt Trauma and Elective Populations: A Retrospective Comparative Study of Outpatient Orthopaedic Care.
Authors: Nguyen MP
Journal: Clinical orthopaedics and related research
mental health
psychology
open access
Abstract
The N-terminal cleavage product of B-type natriuretic peptide (NT-proBNP) is a marker of heart failure, as NT-proBNP values are associated with left ventricular diastolic and systolic dysfunction [, ]. General practitioners, emergency physicians, and cardiologists use NT-proBNP levels for heart failure screening and diagnosis. NT-proBNP levels rise with age and are higher in women than in men []. However, the current guidelines of the American Heart Association (AHA) and the European Society of Cardiology (ESC) recommend an ambulatory rule-out cut-off value of 125 pg/mL independent of sex and age due to limited data in higher age groups [, ]. Thus, sensitivity is excellent and only a few patients are missed, but specificity is low and upper reference limits are supposed to be substantially higher in older individuals [–]. Using an age- and sex-independent cut-off value leads to a large number (about 74% in Belgium) of unnecessary cardiologic referrals in patients aged 80 years and older []. The need for age-dependent cut-off values is further intensified, as about 70% of all NT-proBNP measurements are done in older patients []. Despite the evident gap of knowledge and clinical need, reports on NT-proBNP distribution in the older population and their healthy subgroups are still scarce [, ]. The AugUR study was tailored to the needs of the elderly population, aged ≥ 70 years, living in/around the city of Regensburg, Germany, to further the understanding of risk factors and biomarkers for age-related diseases (Age-related diseases: understanding genetic and non-genetic influences—a study at the University of Regensburg).