The N-terminal pro brain natriuretic peptide is the best predictor of mortality during hospitalization in patients with low risk of sepsis-related organ failure

Abstract

IntroductionThe purpose of this study was to investigate the value of N-terminal pro brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and procalcitonin (PCT) in predicting mortality in septic patients during hospitalization with mortality risk <10% evaluated by Sepsis-related Organ Failure Assessment (SOFA). Material and methodsProspective, observational study performed in sepsis patients with SOFA risk <10%. We obtained levels of biomarkers in the first 72h after admission in hospital. All patients were monitored during hospitalization or until death. We used ROC curves to determine area under curve (AUC) and identify the best cutoff concentrations to predict mortality. ResultsA total of 174 patients were analyzed. Seventeen (9.8%) patients died during hospitalization. The AUC of NT-proBNP was 0.793 (95% CI 0.686–0.9; p<0.0005) compared to AUC of CRP (0.728; 95% CI 0.617–0.839; p=0.004) and AUC of PCT (0.684; 95% CI 0.557–0.811; p=0.019). Factors independently associated with in-hospital mortality were NT-proBNP>1330pg/ml (OR=23.23; 95% CI 2.92–182.25; p=0.003) and to have predisposing factors (OR=3.05; 95% CI 1.3–9.3; p=0.044). ConclusionsIn patients with low mortality risk according to SOFA score, NT-proBNP obtained in the first 72h after admission prove to be a powerful predictor of mortality. Their implementations in clinical practice would improve the predictive ability of clinical severity scores.