PURPOSE: Little is known about relationship of Pro-BNP to outcome in septic patients. We sought to look at the prevalence of high Pro-BNP levels in patients with sepsis and its relationship to morbidity and mortality.
METHODS: Chart review of septic patients with Pro-BNP. Charts reviewed for demographics, admitting diagnosis, co-morbidities, Pro-BNP levels, ejection fraction (EF), Troponin-I levels, number of days in ICU & hospital, and final outcome. The study group was divided into two groups; Group A: those with elevated Pro-BNP levels (>1000 pg/ml) and Group B: those with Pro-BNP levels (<1000 pg/ml).
RESULTS: 50 septic patients had Pro-BNP levels with mean age of 65, 50% female and 88% African American. Mean Pro-BNP in the group was 11239 pg/ml. There were 42 (84%) out of 50 patients in group A and 8 (16%) patients in group B. Mean Pro-BNP for group A was 13944 pg/ml. Mean Pro-BNP for group B was 418 pg/ml. 14 out of 50 patients died (28%). 12 of those who died have Pro-BNP >1000. Mortality rate was 28.5% in group A compared to 25% in group B (P-value =0.77). The mean Pro-BNP level was higher among survivals (12482) compared to those who died (10185), (P>0.05). 70% of the study population have EF >50% and 50% of patients had elevated Troponin I levels. Comparing the Pro-BNP levels with both the EF and Troponin-I levels we found no significant relationship between high Pro-BNP levels and both Low EF (<50%) or elevated troponin, (P=0.72 and P=0.45 respectively). Group A patients stayed in ICU 11 days and in hospital 20 days compared to 6 days in ICU and 15 days in hospital for group B, which was not statistically significant (T score was <2).
CONCLUSION: Elevated Pro-BNP level is common in sepsis patients regardless of their ejection fraction or presence of cardiac ischemia, however no statistically significant correlation between Pro-BNP levels and morbidity or mortality in these patients.
CLINICAL IMPLICATIONS: Pro-BNP cannot be used as a prognostic indicator in septic patients.
DISCLOSURE: Cheikh Ould Ethmane, No Financial Disclosure Information; No Product/Research Disclosure Information