N-terminal pro-brain natriuretic peptide is an independent predictor of mortality in patients with sepsis. (26th October 2021)

• Record Type: Journal Article
• Authors: Biswas, Sagnik; Soneja, Manish; Makkar, Nayani; Farooqui, Faraz Ahmed; Roy, Ambuj; Kumar, Arvind; Nischal, Neeraj; Biswas, Ashutosh; Wig, Naveet; Sood, Rita; Sreenivas, Vishnubhatla
• Is Part Of: Journal of investigative medicine. Volume 70:Number 2(2022)
• Page Start: 369
• Page End: 375
• Publication Date: 2021-10-26
• Subjects: sepsis -- critical care -- biomarkers; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.1136/jim-2021-002017
• Languages: English
• ISSNs: 1081-5589

Abstract

Abstract : This study aims to evaluate the role of cardiac enzymes N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin-I (CTnI) as predictors of outcomes in patients with sepsis. 78 cases with a diagnosis of sepsis were enrolled over a 2-year period. Baseline demographic, Acute Physiology and Chronic Health Evaluation-II (APACHE-II), Simplified Acute Physiology Score-II (SAPS-II), hematologic and biochemical parameters were noted. Serum NT-proBNP and CTnI were evaluated at 24 and 72 hours of admission along with echocardiography. Patients were prospectively followed up until death or discharge. Mean APACHE-II score was 19.8±9.6 and SAPS-II was 44.8±17.2. Survival rate in the study was 47.5% (36 of 78 patients). NT-proBNP was significantly higher in non-survivors with values over 4300 pg/mL at 24 hours and 5229 pg/mL at 72 hours associated with poor outcomes (p<0.05). CTnI was higher among non-survivors than in survivors, but the difference was not significant. APACHE-II score combined with NT-proBNP predicted a poor outcome in 51.2% cases compared with 14.6% cases with APACHE-II alone (p<0.05), while SAPS-II combined with NT-proBNP predicted a poor outcome in 53.6% cases as compared with 9.6% cases with SAPS-II alone (p<0.05). SAPS-II greater than 45 and NT-proBNP values at 72 hours were independent predictors of mortality in patients with sepsis. NT-proBNP is an independent predictor of mortality in patients with sepsis and its combination with APACHE-II and SAPS-II improves the predictive values of the scoring systems.