BNP as discharge criteria for heart failure.
BACKGROUND
Heart failure (HF) is a significant clinical and economic burden in the industrialized world. Advances in pharmaceutical compounds and various medical device technologies along with the use of sophisticated HF clinics have enhanced HF treatment and improved morbidity, mortality, and quality of life. However, hospital readmission rates remain stubbornly high. B-type natriuretic peptide (BNP) levels provide valuable information about a patient's chance of readmission within 30 days of discharge, making BNP a potentially useful tool for making discharge decisions and possibly reducing readmissions.


METHODS
This review examines the strength and level of evidence in key areas to determine if BNP levels could be used as a guide for discharge of HF patients. Although most of the literature describes nonrandomized studies, there is general agreement that BNP levels can be measured accurately and precisely, that BNP levels reflect varying physiologic states, and that they predict outcomes.


CONCLUSIONS
More studies are needed to determine extent of biologic variability. The further use of BNP as a potential discharge marker is promising but awaits additional randomized study that reflects use in a broad-based population.
Caldwell
Mary A
MA
School of Nursing, University of California-San Francisco, Box 0610, San Francisco, CA 94143-0610, USA.
Howie
Jill N
JN
Dracup
Kathleen
K
D015415:Biomarkers / Q000032:analysis; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000032:analysis* / Q000378:metabolism; D010351:Patient Discharge; D010359:Patient Readmission; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain