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.