N-Terminal Pro-B-Type Natriuretic Peptide Predicts Mortality After Major Lower-Limb Amputation for…

Cohort studyAnnals of vascular surgery· Aug 2026

N-Terminal Pro-B-Type Natriuretic Peptide Predicts Mortality After Major Lower-Limb Amputation for Peripheral Arterial Disease.

Henry Lewis Mills, Ateeqahamed Shaikh, Philip C Bennett

Vascular SurgeryCohort studyPrognosisQ2IF 1.8

High pre-operative NT-proBNP predicts higher 1-year mortality after major limb amputation

N-Terminal Pro-B-Type Natriuretic Peptide Predicts Mortality After Major Lower-Limb Amputation for Peripheral Arterial Disease.

Henry Lewis Mills … Philip C Bennett

Annals of vascular surgery · Aug 2026 · Q2 in Surgery

Background

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is known to predict adverse cardiac outcomes in non-cardiac surgery.

Purpose

This study aimed to evaluate the relationship between NT-proBNP levels and mortality following major limb amputation.

Methods

A retrospective cohort study of all patients undergoing major limb amputation at a single tertiary vascular centre between 01/01/2019-31/12/2023 was performed.

n = 409 patients

Results

over 2000 ng/L nearly quadruples the odds of dying within a year

OR 1.00 (95% CI 1.00 to 1.00)

CI excludes the null - significant

More results

There were 433 Amputations in 409 patients analysed (317 [73.20%] male; median age 72 [62.40-80.30] years).

Overall mortality was high at 8 (1.96%) at 30 days, 116 (26.80%) at 1 year and 145 (33.50%) at 2 years.

Median pre-operative NT-proBNP was 1,162 (274-3,721)ng/L, and post-operative NT-proBNP was 1,194 (496-5966) ng/L.

More results

Pre-operative and post-operative NT-proBNP was significantly higher in non-survivors at 1 and 2 years (All p≤0.016).

“

Conclusion · 1 of 2

Patients undergoing major limb amputation experience very high early and medium-term mortality.

Conclusion · 2 of 2

Both pre-operative and post-operative NT-proBNP independently predict mortality beyond age, frailty, and amputation level, supporting its role as a powerful biomarker for peri-operative risk stratification and multidisciplinary decision-making in this high-risk population.

N-Terminal Pro-B-Type Natriuretic Peptide Predicts Mortality After Major Lower-Limb Amputation for Peripheral Arterial Disease.

N-Terminal Pro-B-Type Natriuretic Peptide Predicts Mortality After Major Lower-Limb Amputation for Peripheral Arterial Disease.

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