title: Usefulness of N-terminal pro-B-type natriuretic peptide in patients admitted to the intensive care unit: a multicenter prospective observational study.
abstract: BACKGROUND
  The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients.
  
  
  METHODS
  A total of 1440 patients admitted to 22 ICUs (medical, 14; surgical, six; multidisciplinary, two) in 15 tertiary or university-affiliated hospitals between July 2010 and January 2011 were assessed. Patient data, including NT-pro-BNP levels and Simplified Acute Physiology Score (SAPS) 3 scores, were recorded prospectively in a web-based database.
  
  
  RESULTS
  The median age was 64 years (range, 53-73 years), and 906 (62.9%) patients were male. The median NT-pro-BNP level was 341 pg/mL (104-1,637 pg/mL), and the median SAPS 3 score was 57 (range, 47-69). The ICU mortality rate was 18.9%, and hospital mortality was 24.5%. Hospital survivors showed significantly lower NT-pro-BNP values than nonsurvivors (245 pg/mL [range, 82-1,053 pg/mL] vs. 875 pg/mL [241-5,000 pg/mL], respectively; p < 0.001). In prediction of hospital mortality, the area under the curve (AUC) for NT-pro-BNP was 0.67 (95% confidence interval [CI], 0.64-0.70) and SAPS 3 score was 0.83 (95% CI, 0.81-0.85). AUC increment by adding NT-pro-BNP is minimal and likely no different to SAPS 3 alone.
  
  
  CONCLUSIONS
  The NT-pro-BNP level was more elevated in nonsurvivors in a multicenter cohort of critically ill patients. However, there was little additional prognostic power when adding NT-pro-BNP to SAPS 3 score.
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lim
authors.forename: Shin Ok
authors.initials: SO
authors.lastname: Koh
authors.forename: Won-Il
authors.initials: WI
authors.lastname: Choi
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Gyu Rak
authors.initials: GR
authors.lastname: Chon
authors.forename: Je Hyeong
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae Yeol
authors.initials: JY
authors.lastname: Kim
authors.forename: Jaemin
authors.initials: J
authors.lastname: Lim
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Park
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Lee
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Jisook
authors.initials: J
authors.lastname: Park
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul St, Mary's Hospital, The Catholic University of Korea, 505 Banpo-Dong, Seoul, Seocho-Gu 137-701, South Korea. cmcksc@catholic.ac.kr.
authors.forename: Seok Chan
authors.initials: SC
authors.lastname: Kim
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000628:therapy; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010343:Patient Admission / Q000639:trends*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain