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N-terminal pro-brain natriuretic peptide is an independent predictor of mortality in patients with sepsis

Sagnik Biswas, Manish Soneja, Nayani Makkar, Faraz Ahmed Farooqui, Ambuj Roy, Arvind Kumar, Neeraj Nischal, Ashutosh Biswas, Naveet Wig, Rita Sood, Vishnubhatla Sreenivas
DOI: 10.1136/jim-2021-002017 Published 25 January 2022
Sagnik Biswas
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Manish Soneja
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Nayani Makkar
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Faraz Ahmed Farooqui
2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Ambuj Roy
2 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Arvind Kumar
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Neeraj Nischal
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Ashutosh Biswas
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Naveet Wig
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Rita Sood
1 Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Vishnubhatla Sreenivas
3 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Abstract

This study aims to evaluate the role of cardiac enzymes N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin-I (CTnI) as predictors of outcomes in patients with sepsis.

78 cases with a diagnosis of sepsis were enrolled over a 2-year period. Baseline demographic, Acute Physiology and Chronic Health Evaluation-II (APACHE-II), Simplified Acute Physiology Score-II (SAPS-II), hematologic and biochemical parameters were noted. Serum NT-proBNP and CTnI were evaluated at 24 and 72 hours of admission along with echocardiography. Patients were prospectively followed up until death or discharge.

Mean APACHE-II score was 19.8±9.6 and SAPS-II was 44.8±17.2. Survival rate in the study was 47.5% (36 of 78 patients). NT-proBNP was significantly higher in non-survivors with values over 4300 pg/mL at 24 hours and 5229 pg/mL at 72 hours associated with poor outcomes (p<0.05). CTnI was higher among non-survivors than in survivors, but the difference was not significant. APACHE-II score combined with NT-proBNP predicted a poor outcome in 51.2% cases compared with 14.6% cases with APACHE-II alone (p<0.05), while SAPS-II combined with NT-proBNP predicted a poor outcome in 53.6% cases as compared with 9.6% cases with SAPS-II alone (p<0.05). SAPS-II greater than 45 and NT-proBNP values at 72 hours were independent predictors of mortality in patients with sepsis.

NT-proBNP is an independent predictor of mortality in patients with sepsis and its combination with APACHE-II and SAPS-II improves the predictive values of the scoring systems.

Footnotes

  • Contributors SB, MS, NM, AK, AB, RS, NW, NN, AR and FAF were involved in the study design and execution. SB, MS and VS were involved in data collection and analysis. The manuscript was drafted by SB, NM and MS. The final draft was reviewed and inputs taken from all the authors. MS is the guarantor of this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Data availability statement

Data are available upon reasonable request.

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Vol 70 Issue 2 Table of Contents
Journal of Investigative Medicine: 70 (2)
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N-terminal pro-brain natriuretic peptide is an independent predictor of mortality in patients with sepsis
Sagnik Biswas, Manish Soneja, Nayani Makkar, Faraz Ahmed Farooqui, Ambuj Roy, Arvind Kumar, Neeraj Nischal, Ashutosh Biswas, Naveet Wig, Rita Sood, Vishnubhatla Sreenivas
Journal of Investigative Medicine Feb 2022, 70 (2) 369-375; DOI: 10.1136/jim-2021-002017

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N-terminal pro-brain natriuretic peptide is an independent predictor of mortality in patients with sepsis
Sagnik Biswas, Manish Soneja, Nayani Makkar, Faraz Ahmed Farooqui, Ambuj Roy, Arvind Kumar, Neeraj Nischal, Ashutosh Biswas, Naveet Wig, Rita Sood, Vishnubhatla Sreenivas
Journal of Investigative Medicine Feb 2022, 70 (2) 369-375; DOI: 10.1136/jim-2021-002017
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N-terminal pro-brain natriuretic peptide is an independent predictor of mortality in patients with sepsis
Sagnik Biswas, Manish Soneja, Nayani Makkar, Faraz Ahmed Farooqui, Ambuj Roy, Arvind Kumar, Neeraj Nischal, Ashutosh Biswas, Naveet Wig, Rita Sood, Vishnubhatla Sreenivas
Journal of Investigative Medicine Feb 2022, 70 (2) 369-375; DOI: 10.1136/jim-2021-002017
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