Prognostic value of N–terminal pro B–type natriuretic peptide and troponin I in children with dengue shock syndrome

Abstract

Objective: To investigate the contribution of N-terminal pro B-type natriuretic peptide (NT-pro BNP) and troponin I to mortality in children with dengue shock syndrome. Methods: A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam. Detailed clinical histories, physical examinations, and laboratory parameters, including NT-pro BNP and troponin I, were recorded. A comparison between survival and non-survival was carried out to identify factors influencing mortality. Results: A total of 107 patients with a median age of 9 years were included in the study. Among them, 63.6% (68/107) presented with compensated shock, 36.4% (39/107) had hypotensive shock, 23.4% (25/107) required mechanical ventilation, and 12.1% (13/107) died. The NT-pro BNP levels were 3.9 pmol/L (IQR: 1.9, 10.3) and 15.2 pmol/L (5.8, 46.3), while the median high sensitivity troponin I levels were 20 pg/L (6, 95) and 62 pg/L (12, 325) at the first and second measurements, respectively. The mortality group exhibited higher rates of hypotensive shock, prolonged shock, lactate levels, liver damage, NT-pro BNP, and troponin I levels. Hypotensive shock (OR 12.96, 95% Cl 2.70-62.30, P=0.004), prolonged shock (OR 39.40, 95% CI 6.68-232.70, P<0.001), AST > 1 000 IU/L (OR 9.50, 95% CI 2.63-34.34, P=0.041), and NT-pro BNP > 7 pmol/L (OR 44.40, 95% CI 5.44-362.20, P=0.001) were identified as predictive factors for mortality in dengue shock syndrome. Conclusions: The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.