Predictive value of N-terminal pro-brain natriuretic peptide in combination with the sequential organ failure assessment score in sepsis

摘要

Background The prognostic power of n-terminal pro-brain natriuretic peptide (NT-proBNP) in sepsis is disputable and unstable among different models.We attempt to evaluate the prognostic potential of NT-proBNP in combination with the sequential organ failure assessment (SOFA) score in sepsis.Methods In this retrospective study,100 consecutive sepsis patients were enrolled.Clinical data such as admission SOFA,the Acute Physiologic and Chronic Health Evaluation score,shock prevalence,use of lung protective ventilation,vasopressors,and glucocorticoids were recorded.Additionally,serum creatinine (Scr1 and Scr3) and NT-proBNP (NT-proBNP1 and NT-proBNP3) were assayed and evaluated at admission and on day 3 respectively.Results △NT-proBNP (NT-proBNP3 minus NT-proBNP1) (P ＜0.001,Hazard ratio (HR)=1.245,95％ confidence interval (C/),1.137-1.362) and admission SOFA (P ＜0.001,HR=1.197,95％ C/,1.106-1.295) were independently related to in-hospital mortality.Their combination was a more robust predictor for in-hospital mortality than either of them individually.Patients with high △NT-proBNP and SOFA had the poorest prognosis.Conclusions In our study,both △NT-proBNP and SOFA were independent predictors of septic patients' prognosis.Moreover,the combination of △NT-proBNP and admission SOFA provided a novel strategy that contained information regarding both the response to treatment and sepsis severity.