title: Retrospective study on prognostic importance of serum procalcitonin and amino-terminal pro-brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population.
abstract: BACKGROUND
  Timely decision making in Intensive Care Unit (ICU) is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV) are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED) in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed.
  
  
  RESULTS
  Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643) and morbidity (P = 0.000, AUC = 0.763), comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045).
  
  
  CONCLUSIONS
  The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.
authors.affiliation: Institute of Critical Care and Anaesthesiologoy, Medanta The Medicity, Gurgaon, Haryana, India.
authors.forename: Chitra
authors.initials: C
authors.lastname: Mehta
authors.forename: Babita
authors.initials: B
authors.lastname: Dara
authors.forename: Yatin
authors.initials: Y
authors.lastname: Mehta
authors.forename: Ali M
authors.initials: AM
authors.lastname: Tariq
authors.forename: George V
authors.initials: GV
authors.lastname: Joby
authors.forename: Manish K
authors.initials: MK
authors.lastname: Singh
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000097:blood*; D003422:Critical Care / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; D014662:Vasoconstrictor Agents; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002116:Calcitonin