Abstract
BackgroundThis article aimed to study the value of brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for predicting the prognosis in cancer patients with sepsis.MethodsA cohort of 233 cancer patients with sepsis admitted to our ICU from January 2017 to October 2020 was included in this retrospective study. The data of BNP and cTnI on the first day (d1) and the third day(d3) after entering ICU, blood lactate (Lac), procalcitonin (PCT), Leucocyte and Sequential Organ failure assessment (SOFA) scores within 24 hr of entering ICU, the incidence of septic shock, acute kidney injury(AKI), acute respiratory failure (ARF) or sepsis-induced myocardial dysfunction(SIMD) in ICU, fluid balance in 24 hr and 72 hr after entering ICU, time of mechanical ventilation(MV), length of stay, emergency surgery were collected. According to 28-day mortality, patients were divided into survival group (190 cases) and death group (43 cases). All the above variables were compared.ResultsBNP was an independent predictor for the mortality in these patients (P < 0.05).While cTnI was not. BNP on d3 in 681.5 pg/ml predicted the mortality with a sensitivity of 91.5 % and a specificity of 88.7 %. All patients were divided into the new two groups following the cutoff value of BNP on d3(681.5pg/ml), and the survival curve showed a significant difference with Kaplan-Meier analysis (P < 0.05). BNP had statistical differences between four groups based on the comorbidities(septic shock, AKI, ARF or SIMD), but cTnI was not.ConclusionsBNP was a great predictor for the prognosis of cancer patients with sepsis, while cTnI was not.
Highlights
Sepsis is “a life-threatening condition that arises when the body’s response to infection injures its own tissues” [1]
It can be seen that brain natriuretic peptide (BNP) on d3, Sequential Organ failure assessment (SOFA) score, and 72 hr fluid balance were independent risk factors for mortality of patients (Table 2). 3
It can be seen that BNP on d3 had the largest area of Receiver operating characteristic (ROC) curve, and it had the best sensitivity and specificity
Summary
Sepsis is “a life-threatening condition that arises when the body’s response to infection injures its own tissues” [1]. More progress has been made in the treatment for sepsis, it is still one of the common causes of death in critically ill patients worldwide [2]. Poor regulation of normal immune responses caused by sepsis can result in a variety of adverse reactions, including multi-system organ dysfunction in several cases [4]. Sepsis induced myocardial dysfunction(SIMD) is common, with an incidence of about 40 %, which usually indicates a significant poor prognosis in sepsis [2,3,4,5].The application of BNP and cTnI in congestive heart failure and acute coronary syndromes has been extensively recognized and accepted [6, 7]. This article aimed to study the value of brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for predicting the prognosis in cancer patients with sepsis
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