title: [Prognostic role of NT-proBNP in emergency department in the elderly with acute heart failure].
abstract: OBJECTIVE
  To determine prognostic role of NT-proBNP as predictor of 30 day-mortality and readmission in the elderly with acute heart failure (AHF) treated in Spanish Emergency Departments (EDs), and to analyse the confounding factors when the NT-proBNP value is interpreted.
  
  
  METHODS
  A multicentre and multi-purpose cohort study with prospective follow-up was conducted on all patients aged 65 years or older with AHF treated in Spanish EDs. The variables recorded include demographic characteristics, comorbidity, details of episode, and NT-proBNP value. The outcome variables were 30 day-mortality and readmission. An NT-proBNP ≥ 5,180 pg/ml was adopted as the cut-off limit. The statistical package SPSS 18.0 was used to analyse the data.
  
  
  RESULTS
  A total of 585 patients were included, with a mean age of 80.4 (SD: 6.9) years old. The cut-off NT-proBNP ≥ 5,180 pg/ml was independently associated with a severely impaired glomerular filtration (<30 ml/h) (P < .001) and severe episode (NYHA II-IV) (P = .012). The NT-proBNP area under curve (AUC) for 30 day-mortality was 0.71 (CI 95%: 0.63-0.77; P < .001) and for 30 day-readmission, was 0.50 (CI 95%: 0.45-0.56; P = .846). A multivariable analysis showed that the cut-off NT-proBNP ≥ 5,180 pg/ml was an independent factor associated with 30 day-mortality in the elderly with AHF attended in Spanish EDs.
  
  
  CONCLUSIONS
  The NT-proBNP value is associated with short-term mortality in the elderly with AHF attended in the EDs independently of the presence of confounding factors, such as the severity of the episode and glomerular filtration reduction, but not with 30 day-readmission.
authors.affiliation: Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España. fjjms@hotmail.com
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martín Sánchez
authors.forename: Marisa
authors.initials: M
authors.lastname: Covarrubias
authors.forename: Claudia
authors.initials: C
authors.lastname: Terán
authors.forename: Pere
authors.initials: P
authors.lastname: Llorens
authors.forename: Pablo
authors.initials: P
authors.lastname: Herrero
authors.forename: Javier
authors.initials: J
authors.lastname: Jacob
authors.forename: Víctor
authors.initials: V
authors.lastname: Gil
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández
authors.forename: Oscar
authors.initials: O
authors.lastname: Miró
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Acute heart failure; Anciano; Elderly; Insuficiencia cardiaca aguda; NT-proBNP