BNP and NT-proBNP, predictors of 1-year mortality in nursing home residents.
OBJECTIVE
To investigate 1-year mortality prediction of B type natriuretic peptide (BNP) and N terminal-proBNP (NT-proBNP) in institutionalized elderly with multiple morbidities.


METHODS
Prospective cross-sectional study.


METHODS
One nursing home.


METHODS
Ninety-three residents (mean age 81 +/- 3 years, 66% female). Residents with serious cognitive impairments, aphasia, or metastatic cancer were excluded.


METHODS
Clinical assessment, immobilization, medical history, electrocardiogram (ECG), echocardiogram, blood samples. One general geriatrician assessed noncardiovascular diseases; a cardiologist panel established the diagnosis of chronic heart failure (CHF). Subjects were tracked for 1 year as far as status of death.


RESULTS
Eighteen of 93 enrolled individuals died. BNP was significantly higher in nonsurvivors compared with survivors (138 [49-753] versus 87 [27-162], P = .029), NT-proBNP was higher but did not reach significance 1382 (193-5683) versus 335 (175-900) pg/mL (interquartile range [IQR], P = .059). The adjusted value on 1-year mortality of 6 predefined chronic diseases, immobilization, age, sex, NT-proBNP, and BNP was estimated by means of Cox proportional hazard regression analyses. Finally, both for NT-proBP and BNP, a mutually adjusted multivariate Cox proportional hazard analysis with the covariates presented that BNP and NT-proBNP predicted 1-year mortality significantly (hazard ratio [HR] 1.67 and P = .000, HR 0.60 and P = .000, respectively). The mortality risk increased at rising BNP and NT-proBNP levels.


CONCLUSIONS
BNP and NT-proBNP are predictors of 1-year mortality independently of age, gender, and morbidity. The mortality risk increases at elevating natriuretic peptide concentrations. We postulate that plasma levels of BNP and NT-proBNP are also of use to predict prognosis in institutionalized elderly with multiple morbidity.
Barents
Maaike
M
Nursing Home Het Zonnehuis, Zuidhorn, the Netherlands. mbarents@planet.nl
Hillege
Hans H L
HH
van der Horst
Iwan C C
IC
de Boer
Rudolph A
RA
Koster
J
J
Muskiet
Frits A J
FA
de Jongste
Mike J L
MJ
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality; D020097:Natriuretic Peptide, Brain / Q000032:analysis* / Q000097:blood; D009735:Nursing Homes; D010446:Peptide Fragments / Q000032:analysis* / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies
D015415:Biomarkers; D010446:Peptide Fragments; D020097:Natriuretic Peptide, Brain