Usefulness of N-terminal pro-B-type natriuretic peptide in patients admitted to the intensive care unit: a multicenter prospective observational study

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• 作者：Chin Kook Rhee (21)
  So Yeon Lim (22)
  Shin Ok Koh (23)
  Won-Il Choi (24)
  Young-Joo Lee (25)
  Gyu Rak Chon (16)
  Je Hyeong Kim (17)
  Jae Yeol Kim (18)
  Jaemin Lim (19)
  Sunghoon Park (20)
  Ho Cheol Kim (21)
  Jin Hwa Lee (22)
  Ji Hyun Lee (23)
  Jisook Park (24)
  Younsuck Koh (25)
  Gee Young Suh (22)
  Seok Chan Kim (21)
  
• 关键词：N ; terminal pro ; B ; type natriuretic peptide ; Intensive care unit ; Critical care ; Prognosis
• 刊名：BMC Anesthesiology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：255 KB
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  4. Omland T, Persson A, Ng L, O’Brien R, Karlsson T, Herlitz J, Hartford M, Caidahl K: N-terminal pro-B-type natriuretic peptide and long-term mortality in acute coronary syndromes. / Circulation 2002, 106:2913-918. CrossRef
  5. Okkonen M, Varpula M, Linko R, Perttila J, Varpula T, Pettila V: N-terminal-pro-BNP in critically ill patients with acute respiratory failure: a prospective cohort study. / Acta Anaesthesiol Scand 2011, 55:749-57. CrossRef
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  7. Almog Y, Novack V, Megralishvili R, Kobal S, Barski L, King D, Zahger D: Plasma level of N terminal pro-brain natriuretic peptide as a prognostic marker in critically ill patients. / Anesth Analg 1809-815, 2006:102.
  8. Meyer B, Huelsmann M, Wexberg P, Delle Karth G, Berger R, Moertl D, Szekeres T, Pacher R, Heinz G: N-terminal pro-B-type natriuretic peptide is an independent predictor of outcome in an unselected cohort of critically ill patients. / Crit Care Med 2007, 35:2268-273. CrossRef
  9. Kotanidou A, Karsaliakos P, Tzanela M, Mavrou I, Kopterides P, Papadomichelakis E, Theodorakopoulou M, Botoula E, Tsangaris I, Lignos M, Ikonomidis I, Ilias I, Armaganidis A, Orfanos SE, Dimopoulou I: Prognostic importance of increased plasma amino-terminal pro-brain natriuretic peptide levels in a large noncardiac, general intensive care unit population. / Shock (Augusta, Ga) 2009, 31:342-47. CrossRef
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  11. Lim SY, Koh SO, Jeon K, Na S, Lim CM, Choi WI, Lee YJ, Kim SC, Chon GR, Kim JH, Kim JY, Lim J, Rhee CK, Park S, Kim HC, Lee JH, Park J, Koh Y, Suh GY: Validation of SAPS3 admission score and its customization for use in Korean intensive care unit patients: a prospective multicentre study. / Respirology (Carlton, Vic) 2013, 18:989-95. CrossRef
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  18. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/14/16/prepub
  
• 作者单位：Chin Kook Rhee (21)
  So Yeon Lim (22)
  Shin Ok Koh (23)
  Won-Il Choi (24)
  Young-Joo Lee (25)
  Gyu Rak Chon (16)
  Je Hyeong Kim (17)
  Jae Yeol Kim (18)
  Jaemin Lim (19)
  Sunghoon Park (20)
  Ho Cheol Kim (21)
  Jin Hwa Lee (22)
  Ji Hyun Lee (23)
  Jisook Park (24)
  Younsuck Koh (25)
  Gee Young Suh (22)
  Seok Chan Kim (21)
  
  21. Division of Pulmonary and Critical Care Medicine, Department of Medicine, College of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
  22. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, South Korea
  23. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bundang CHA hospital CHA University, Bundang, South Korea
  24. Department of Multimedia, Seoul Women’s University, Seoul, South Korea
  25. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
  16. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chungju hospital, School of medicine of Konkuk University, Chungju, South Korea
  17. Sleep and Critical Care Medicine, Department of Medicine, Korea University Ansan Hospital, Ansan, South Korea
  18. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
  19. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Gangneung Asan Hospital, Gangneung, University of Ulsan Medical College of internal medicine, Gangneung, South Korea
  20. Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Ahnyang, South Korea
  
• ISSN：1471-2253

文摘

Background The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients. Methods A total of 1440 patients admitted to 22 ICUs (medical, 14; surgical, six; multidisciplinary, two) in 15 tertiary or university-affiliated hospitals between July 2010 and January 2011 were assessed. Patient data, including NT-pro-BNP levels and Simplified Acute Physiology Score (SAPS) 3 scores, were recorded prospectively in a web-based database. Results The median age was 64?years (range, 53-3?years), and 906 (62.9%) patients were male. The median NT-pro-BNP level was 341?pg/mL (104-,637?pg/mL), and the median SAPS 3 score was 57 (range, 47-9). The ICU mortality rate was 18.9%, and hospital mortality was 24.5%. Hospital survivors showed significantly lower NT-pro-BNP values than nonsurvivors (245?pg/mL [range, 82-,053?pg/mL] vs. 875?pg/mL [241-,000?pg/mL], respectively; p-lt;-.001). In prediction of hospital mortality, the area under the curve (AUC) for NT-pro-BNP was 0.67 (95% confidence interval [CI], 0.64-.70) and SAPS 3 score was 0.83 (95% CI, 0.81-.85). AUC increment by adding NT-pro-BNP is minimal and likely no different to SAPS 3 alone. Conclusions The NT-pro-BNP level was more elevated in nonsurvivors in a multicenter cohort of critically ill patients. However, there was little additional prognostic power when adding NT-pro-BNP to SAPS 3 score.