Prognostic significance of brain natriuretic peptide obtained in the ED in patients with SIRS or sepsis

Purpose: The study was conducted to know the significance of brain natriuretic peptide (BNP) for prognosis of septic patients. Methods: The subjects were 1000 patients selected in emergency department of Beijing Chaoyang Hospital of the Capital Medical University (Beijing, China) and were classified into 3 groups as follows: systemic inflammatory response syndrome (SIRS), non-SIRS, and sepsis groups. Plasma serum brain natriuretic peptide (BNP) levels and the positive detection rates of BNP were examined. The BNP level of 100 pg/mL or more was regarded as positive, and then the positive detection rates of BNP of these groups were compared. The prognostic values of BNP and APACHE (Acute physiology and chronic health evaluation) II score for the 28-day mortality were investigated, and their cutoff values for death were determined. Results: There were significant differences in the positive detection rates of BNP between any 2 groups and in 28-day mortality between the patients with SIRS and non-SIRS groups. The BNP level had positive correlation to APACHE II score in 3 groups. Brain natriuretic peptide level of more than 113 pg/mL was independent predictor of death in septic patients. Conclusion: The positive rates of BNP in SIRS and septic patients were significantly higher than that of non-SIRS patients, and this is an index for unfavorable prognosis in septic patients. (C) 2009 Elsevier Inc. All rights reserved.