Clinical value of N-terminal pro-brain natriuretic peptide and troponin I plasma levels in elderly patients with sepsis

Abstract

Objective To evaluate the clinical significance for assessment and prognosis of elder patients with sepsis by way of detecting plasma NT-proBNP and cTnl levels. Methods It was a prospective trial conducted. A total of 145 elderly patients with sepsis were admitted to the emergency observation center and the emergency ward from January 2011 through January 2013. Of them, there were 84 patients with mild sepsis, 45 patients with severe sepsis, and 16 patients with septic shock. Plasma levels of NT-proBNP and cTnI were assayed immediately after admission. The LVEF value was determined by echocardiography. The APACHE Ⅱ score was also determined. In the following 28 days, the survival of patients with severe sepsis and septic shock were investigated. Data of laboratory findings were analyzed for comparison between the survival group （ n = 49 ） and death group （ n = 12）. Results The plasma levels of NT-proBNP and cTnI in the severe sepsis group [ （1375.48 ±537.15） pg/mL, （0. 53 ±0. 45） μg/L] and in the septic shock group [ （2735.73 ±907. 17） pg/mL, （1.94 ± 1.14） μg/L] were signifieantly higher than those in themild sepsis group [ （554. 12 ± 107.48 ） pg/mL, （0. 08 ± 0. 07 ） μg/L]. The differences among three groups were statistically significant （ P 〈 0. 01 ）. The plasma levels of NT-proBNP and cTnI, and the APACHE score of the death group were significantly higher than those of the survival group. The LVEF values of the death group were significantly lower than that of the survival group （ P 〈 0. 05 ）. The plasma levels of NT-proBNP and cTnI and the APACHE I/ score were positively correlated. Conclusions The plasma levels of NT-proBNP and cTnI can be used for severity and prognosis assessment in patients with sepsis. Key words: Elderly; Sepsis; Severe sepsis; Septic shock; N-terminal pro-brain natriureticpeptide ; Troponin I ; Ejection fraction ; Prognosis