Serum N-terminal pro-brain natriuretic peptide level is a significant prognostic factor in patients with severe sepsis among Southwest Chinese Population

X.-H. Zhang, Y. Dong, Y.-D. Chen, P. Zhou, J.-D. Wang, F.-Q. Wen

Department of Emergency Intensive Care Unit, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, People’s Republic of China. yundye18@hotmail.com

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• Infectious Diseases

BACKGROUND: This study aimed to determine the predictive value of elevated N-terminal pro-brain natriuretic peptide (NTproBNP) for mortality in patients with severe sepsis.

PATIENTS AND METHODS: This was a retrospective study in Emergency Department of Sichuan Provincial People’s Hospital, and patients were screened between January 1, 2009 and December 31, 2011. Demographic and clinical data as well as Acute Physiology And Chronic Health Evaluation II (APACHE II) and Sepsis Organ Failure Assessment (SOFA) scores were collected within the first day of admission. Survival was determined to establish its association with the NT-proBNP using logistic regression and receiver operating characteristic (ROC) curve.

RESULTS: A total of 171 patients with severe sepsis were analyzed. The median APACHE IIⅡ and SOFA scores were 11 (IQR, 7-16) and 3 (IQR, 1-5), respectively. The median C-reactive protein (CRP), procalcitonin (PCT) and NT-proBNP was 10.3 mg/dL (IQR, 3.4-21.4 mg/dL), 0.4 ng/mL (IQR, 0.2-3.6 ng/mL), and 954 (321-1576) pg/mL, respectively. The median NT-proBNP in survivors was 584 pg/mL (IQR, 321-875 pg/mL) versus 1271 (IQR, 851-1576 pg/mL) in nonsurvivors (p < 0.001). In the ROC curves, the area value was 0.89 for serum NT-proBNP, and its potent cutoff value was 1500 pg/mL. After multivariate regression analysis, NT-proBNP was significantly correlated with the mortality of severe sepsis (OR = 1.58, 95% CI 1.36-1.77).

CONCLUSIONS: Serum NT-proBNP is frequently increased in severe sepsis patients, and non-survivors have higher levels than survivors. High levels of admission NT-proBNP are associated with mortality.

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