title: Natriuretic peptide levels taken following unplanned admission to a cardiology department predict the duration of hospitalization.
abstract: Natriuretic peptide (NP) levels are routinely employed as useful diagnostic and prognostic tools in the evaluation of patients with heart failure (HF). As hospitalization is the major consumer of healthcare resources, the prognostic power of admission NPs with regard to the duration of hospitalization deserves further investigation.
  
  
  
  We assessed retrospectively the association between NP values sampled shortly following unplanned admission and the duration of hospitalization in 2978 patients admitted to a cardiology department. Duration of hospitalization (hours) and survival were determined by interrogation of the electronic medical records system. Associations with peptide levels were estimated using regression models and receiver operating characteristic (ROC) analysis. The results demonstrate a significant positive relationship between NP levels and the duration of hospitalization, after adjusting for age (P < 0.001). The median duration of hospitalization for the lowest BNP and NT-proBNP quintiles were 80 and 97 h, respectively, vs. 224.5 and 236 h for the highest quintiles. Using cut-off levels of 115 pmol/L for BNP and 390 pmol/L for NT-proBNP, the peptides have a positive predictive value of 78% and 85% for a stay >4 days. During follow-up, NP levels were strongly predictive of all-cause mortality.
  
  
  
  The results quantify the strong relationship between NP levels taken following an unplanned admission to a cardiology department and the duration of hospitalization. This information permits improved identification of a patient population likely to require a prolonged hospital stay and consume more healthcare resources. Such patients may require a more aggressive diagnostic, treatment, and management strategy.
authors: Stavanger University Hospital, Stavanger, Norway.
authors: Marte
authors: M
authors: Asphaug
authors: Stavanger University Hospital, Stavanger, Norway.
authors: Øyvind
authors: Ø
authors: Skadberg
authors: Stavanger University Hospital, Stavanger, Norway.
authors: Ingvild
authors: I
authors: Dalen
authors: Stavanger University Hospital, Stavanger, Norway.|University of Bergen, Bergen, Norway.
authors: Kenneth
authors: K
authors: Dickstein
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000097:blood*; D016507:Cardiology Service, Hospital; D009202:Cardiomyopathies / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000097:blood*; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017202:Myocardial Ischemia / Q000097:blood*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009664:Norway; D010446:Peptide Fragments / Q000097:blood*; D016016:Proportional Hazards Models; D012372:ROC Curve; D012141:Respiratory Tract Infections / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Duration of hospitalization; Heart failure; Natriuretic peptides