Critical Care |

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Factor in Critically Ill Patients With Sepsis FREE TO VIEW

Xubin Huang, PhD; Jun Zhang, MD; Wanmei He, MD; Xinyan Huang, MD; Mian Zeng, MD
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the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

Chest. 2015;148(4_MeetingAbstracts):338A. doi:10.1378/chest.2280202
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SESSION TITLE: Sepsis and Shock Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The efficacy of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) acting as a prognostic factor in critically ill patients with sepsis is controversial. The present study prospectively assessed whether NT-pro-BNP measured at intensive care unit (ICU) admission is predictive of 28-day mortality in a cohort of critically ill patients with sepsis.

METHODS: A total of 119 consecutive patients with sepsis admitted to the Medical Intensive Care Unit (medical ICU), in a tertiary university hospital where there was a Cardiology ICU and Surgical ICU, during a 12-month period between January 2014 and December 2014, were assessed. Patients with recent acute coronary syndromes or major surgery in a month were excluded.

RESULTS: The median age was 61 yr (range, 18-89 yr; IQR, 48-73), and 59.7% of the patients were male. The median level of NT-pro-BNP on ICU admission was 3,351.0 pg/mL (range, 32.0-236,823.0 pg/mL; IQR, 945.9-14,149.0pg/mL), and the median APACHE II score was 23 (range, 10-43). The 28-day mortality rate was 53.8%. The 28-day survivors did show significantly lower levels of NT-pro-BNP from non-survivors (1,341.0 pg/mL [range, 32.0-50,145.0 pg/mL] vs. 6,653.0 pg/mL [range,126.4-236,823.0 pg/mL] , P=0.001). In prediction of 28-day mortality, the area under the curve (AUC) for NT-pro-BNP was 0.81 (95% confidence interval [CI], 0.74-0.89) and APACHE II score was 0.67 (95% CI, 0.61-0.75). AUC was 0.77 (95%CI, 0.68-0.85) when NT-pro-BNP was combined with APACHE II.

CONCLUSIONS: The level of NT-pro-BNP was decreased in survivors compared with non-survivors in a cohort of critically ill patients with sepsis in a medical intensive care unit. Moreover, combining NT-pro-BNP with APACHE II score added additional power in predicting 28-day mortality in this cohort of critically ill patients with sepsis.

CLINICAL IMPLICATIONS: The NT-pro-BNP level might be used as a predictor of 28-day mortality in critically ill patients with sepsis in medical ICU.

DISCLOSURE: The following authors have nothing to disclose: Xubin Huang, Jun Zhang, Wanmei He, Xinyan Huang, Mian Zeng

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