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N-terminal pro-brain natriuretic peptide is an independent predictor of mortality in patients with sepsis
  1. Sagnik Biswas1,
  2. Manish Soneja1,
  3. Nayani Makkar1,
  4. Faraz Ahmed Farooqui2,
  5. Ambuj Roy2,
  6. Arvind Kumar1,
  7. Neeraj Nischal1,
  8. Ashutosh Biswas1,
  9. Naveet Wig1,
  10. Rita Sood1,
  11. Vishnubhatla Sreenivas3
  1. 1Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  3. 3Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Manish Soneja, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India; manishsoneja{at}gmail.com

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.

  • sepsis
  • critical care
  • biomarkers

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors SB, MS, NM, AK, AB, RS, NW, NN, AR and FAF were involved in the study design and execution. SB, MS and VS were involved in data collection and analysis. The manuscript was drafted by SB, NM and MS. The final draft was reviewed and inputs taken from all the authors. MS is the guarantor of this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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