title: Plasma level of N terminal pro-brain natriuretic peptide as a prognostic marker in critically ill patients.
abstract: We studied whether N-terminal pro brain natriuretic peptide (NT-pro BNP) measured at intensive care unit admission is an independent predictor of mortality in critically ill patients. We conducted a prospective observational cohort study enrolling 78 patients with APACHE II scores more than 12. Serum NT-pro BNP and cardiac troponin T were measured at admission, and echocardiography was performed within 24 h. The primary end-point was 30-day mortality. The median NT-pro BNP levels of the 22 (28.2%) patients who died were significantly more frequent than that of those who survived (8328 versus 1016 pg/mL; P = 0.001). Patients with NT-pro BNP levels more than 1900 pg/mL had significantly more frequent mortality (47.2% versus 11.9%; P = 0.03). This group also had more frequent moderate to severe left ventricular dysfunction (30.6% versus 9.5%; P = 0.02) and abnormal cardiac troponin T levels (33.3% versus 14.3%; P = 0.05). Multivariate analyses adjusted for APACHE-II revealed that a NT-pro BNP level more than 1900 pg/mL is an independent predictor of mortality.
authors.affiliation: Medical Intensive Care Unit and the Department of Medicine, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. almogya@bgu.ac.il
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Almog
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
authors.forename: Rinat
authors.initials: R
authors.lastname: Megralishvili
authors.forename: Sergio
authors.initials: S
authors.lastname: Kobal
authors.forename: Leonid
authors.initials: L
authors.lastname: Barski
authors.forename: Daniel
authors.initials: D
authors.lastname: King
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain