Usefulness of N-terminal pro-B-type natriuretic peptide in patients admitted to the intensive care unit: a multicenter prospective observational study.

Abstract:

BACKGROUND:The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients. METHODS:A total of 1440 patients admitted to 22 ICUs (medical, 14; surgical, six; multidisciplinary, two) in 15 tertiary or university-affiliated hospitals between July 2010 and January 2011 were assessed. Patient data, including NT-pro-BNP levels and Simplified Acute Physiology Score (SAPS) 3 scores, were recorded prospectively in a web-based database. RESULTS:The median age was 64 years (range, 53-73 years), and 906 (62.9%) patients were male. The median NT-pro-BNP level was 341 pg/mL (104-1,637 pg/mL), and the median SAPS 3 score was 57 (range, 47-69). The ICU mortality rate was 18.9%, and hospital mortality was 24.5%. Hospital survivors showed significantly lower NT-pro-BNP values than nonsurvivors (245 pg/mL [range, 82-1,053 pg/mL] vs. 875 pg/mL [241-5,000 pg/mL], respectively; p < 0.001). In prediction of hospital mortality, the area under the curve (AUC) for NT-pro-BNP was 0.67 (95% confidence interval [CI], 0.64-0.70) and SAPS 3 score was 0.83 (95% CI, 0.81-0.85). AUC increment by adding NT-pro-BNP is minimal and likely no different to SAPS 3 alone. CONCLUSIONS:The NT-pro-BNP level was more elevated in nonsurvivors in a multicenter cohort of critically ill patients. However, there was little additional prognostic power when adding NT-pro-BNP to SAPS 3 score.

journal_name

BMC Anesthesiol

journal_title

BMC anesthesiology

authors

Rhee CK,Lim SY,Koh SO,Choi WI,Lee YJ,Chon GR,Kim JH,Kim JY,Lim J,Park S,Kim HC,Lee JH,Lee JH,Park J,Koh Y,Suh GY,Kim SC,Validation of Simplified acute physiology score3 in Korean Intensive care unit (VSKI) study group &

doi

10.1186/1471-2253-14-16

subject

Has Abstract

pub_date

2014-03-10 00:00:00

pages

16

issn

1471-2253

pii

1471-2253-14-16

journal_volume

14

pub_type

杂志文章,多中心研究