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The N-terminal pro brain natriuretic peptide is the best predictor of mortality during hospitalization in patients with low risk of sepsis-related organ failure.

Authors
  • García Villalba, Eva1
  • Bernal Morell, Enrique2
  • Egea, Mari Paz1
  • Marín, Irene1
  • Alcaraz Garcia, Antonia1
  • Muñoz, Angeles1
  • Vera, MariCarmen1
  • Valero, Salvador1
  • Martinez, Monica1
  • Callejo Hurtado, Victoria1
  • Gomez Verdu, Jose Miguel1
  • Santo, Angela1
  • Cano Sanchez, Alfredo3
  • 1 Sección de Enfermedades Infecciosas, Hospital Reina Sofía, Murcia, España.
  • 2 Universidad Católica San Antonio. Murcia, España. Electronic address: [email protected]
  • 3 Universidad de Murcia, Murcia, España.
Type
Published Article
Journal
Medicina Clínica
Publisher
Elsevier
Publication Date
Sep 08, 2017
Volume
149
Issue
5
Pages
189–195
Identifiers
DOI: 10.1016/j.medcli.2017.02.036
PMID: 28473224
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

The purpose of this study was to investigate the value of N-terminal pro brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and procalcitonin (PCT) in predicting mortality in septic patients during hospitalization with mortality risk<10% evaluated by Sepsis-related Organ Failure Assessment (SOFA). Prospective, observational study performed in sepsis patients with SOFA risk<10%. We obtained levels of biomarkers in the first 72h after admission in hospital. All patients were monitored during hospitalization or until death. We used ROC curves to determine area under curve (AUC) and identify the best cutoff concentrations to predict mortality. A total of 174 patients were analyzed. Seventeen (9.8%) patients died during hospitalization. The AUC of NT-proBNP was 0.793 (95% CI 0.686-0.9; P<.0005) compared to AUC of CRP (0.728; 95% CI 0.617-0.839; P=.004) and AUC of PCT (0.684; 95% CI 0.557-0.811; P=.019). Factors independently associated with in-hospital mortality were NT-proBNP>1,330pg/ml (OR=23.23; 95% CI 2.92-182.25; P=.003) and to have predisposing factors (OR=3.05; 95% CI 1.3-9.3; P=.044) CONCLUSIONS: In patients with low mortality risk according to SOFA score, NT-proBNP obtained in the first 72h after admission prove to be a powerful predictor of mortality. Their implementations in clinical practice would improve the predictive ability of clinical severity scores. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

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