title: Predictive value of N-terminal pro-brain natriuretic peptide in combination with the sequential organ failure assessment score in sepsis.
abstract: BACKGROUND
  The prognostic power of n-terminal pro-brain natriuretic peptide (NT-proBNP) in sepsis is disputable and unstable among different models. We attempt to evaluate the prognostic potential of NT-proBNP in combination with the sequential organ failure assessment (SOFA) score in sepsis.
  
  
  METHODS
  In this retrospective study, 100 consecutive sepsis patients were enrolled. Clinical data such as admission SOFA, the Acute Physiologic and Chronic Health Evaluation score, shock prevalence, use of lung protective ventilation, vasopressors, and glucocorticoids were recorded. Additionally, serum creatinine (Scr1 and Scr3) and NT-proBNP (NT-proBNP1 and NT-proBNP3) were assayed and evaluated at admission and on day 3 respectively.
  
  
  RESULTS
  DNT-proBNP (NT-proBNP3 minus NT-proBNP1) (P < 0.001, Hazard ratio (HR) = 1.245, 95% confidence interval (CI), 1.137 - 1.362) and admission SOFA (P < 0.001, HR = 1.197, 95%CI, 1.106 - 1.295) were independently related to in-hospital mortality. Their combination was a more robust predictor for in-hospital mortality than either of them individually. Patients with high DNT-proBNP and SOFA had the poorest prognosis.
  
  
  CONCLUSIONS
  In our study, both DNT-proBNP and SOFA were independent predictors of septic patients' prognosis. Moreover, the combination of DNT-proBNP and admission SOFA provided a novel strategy that contained information regarding both the response to treatment and sepsis severity.
authors.affiliation: Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Min-Jie
authors.initials: MJ
authors.lastname: Ju
authors.forename: Du-Ming
authors.initials: DM
authors.lastname: Zhu
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: Tu
authors.forename: Yi-Zhou
authors.initials: YZ
authors.lastname: He
authors.forename: Zhang-Gang
authors.initials: ZG
authors.lastname: Xue
authors.forename: Zhe
authors.initials: Z
authors.lastname: Luo
authors.forename: Zhao-Guang
authors.initials: ZG
authors.lastname: Wu
mesh_terms: D000368:Aged; D003404:Creatinine / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D063305:Organ Dysfunction Scores; D010446:Peptide Fragments / Q000097:blood*; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000401:mortality
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine