Association of NT-proBNP with clinical outcomes in children with systemic inflammatory response syndrome

Abstract

N-terminal pro-brain type natriuretic peptide (NT-proBNP) has been reported to have an association with increased morbidity and mortality in adults with septic shock. The relationship between NT-proBNP levels and morbidity/mortality in children with systemic inflammatory response syndrome (SIRS) has not been studied. This was a retrospective study. The inclusion criteria were children (<18 years of age) who met the SIRS criteria and had NT-proBNP obtained between 2011 and 2017. Patients with final primary diagnoses related to cardiac disease were excluded. Patients were divided into 2 groups based on the value of NT-proBNP levels. Our cohort consisted of 44 patients after screening 4004 patients. Primary diagnoses were bacterial infection (n = 35, 80%), viral infection (n = 6, 14%), and Kawasaki disease (n = 3, 7%). Between elevated (n = 26) and non-elevated (n = 18) groups, there was no difference in age groups, gender, race, or final diagnoses. There were 5 deaths (11%). Children in the elevated group were more likely to require intensive care unit admission (odds ratio 20.0), mechanical ventilation (5.0), and inotropic support (9.4). Using receiver operator characteristic curve, the optimal cut-off values of NT-proBNP were 3034 pg/mL for inotropic support and mechanical ventilator use, 818 pg/mL for ICU admission, and 29,988 pg/mL for mortality. NT-proBNP levels were associated with increased morbidity in children with SIRS.