Key result
Elevated admission NT-proBNP predicts ~70% higher short-term mortality and increased long-term death risk.
Why the study?
While the prognostic value of elevated NT-proBNP in heart failure and hypertrophic cardiomyopathy is documented, its predictive efficacy for mortality outcomes across broader patient populations remains inconclusive.
Does elevated serum NT-proBNP predict 30-day and long-term mortality in emergency medical admissions?
Observational (n=58,439)
No
Does elevated serum NT-proBNP predict 30-day and long-term mortality in emergency medical admissions?
Elevated serum NT-proBNP at hospital admission is a strong prognostic indicator for both 30-day and long-term mortality in unselected emergency medical admissions.
Answers are grounded in this paper and cite their sources.
Supports NT-proBNP prognostic value in emergency admissions; extends prior HF observations to unselected medical patients.
Background The prognostic value of elevated serum NT-proB-type Natriuretic Peptide (NT-proBNP) in heart failure and hypertrophic cardiomyopathy is well-documented. However, its there is no conclusive predictive efficacy for mortality outcomes across broader patient populations. Aim Investigation of the prognostic implications of raised serum NT-proB-type Natriuretic Peptide (NT- proBNP) in emergency medical admissions. Methods In this single centre retrospective observational study, we analysed all NT-proBNP results for emergency medical admissions over 114 months, from January 2013 onwards (n=58,439 patients). We recorded mortality data at 30-days and to a maximum of 9.5 years. We employed multivariable logistic regression, Wald testing, Chi square testing and Kaplan-Meier survival curves to assess 30-day in-hospital mortality and a Cox Proportional Hazard model was employed for long term mortality data. Results Over the 114 months of our study, incidence of serum NT-proBNP testing increased from 19.9% to 27.6% (p <0.001). 58,439 patients were included which represented 105,173 emergency admissions. Patients who had NT-proBNP tested were significantly older (median age: 73.2 years vs. 61.1 years, p <0.001), had longer hospitalizations (median stay: 8 days vs. 3.3 days, p <0.001), increased 30-day in- hospital mortality (7.8 [95%CI: 7.4, 8.3] vs. 2.4 [95%CI: 2.3, 2.5] and had higher Acute Illness Severity and Comorbidity Scores. All-cause mortality was significantly increased for patients who had NT- proBNP testing, OR 3.42 [95% CI: 3.17, 3.67]. The Acute Illness Severity score was the most powerful predictor of in-hospital 30-day mortality in those having NT-proBNP tests, OR 6.64 [95% CI: 6.0, 7.39]. Elevated NT-proBNP was significantly associated with 30-day mortality after adjustment for age, gender and comorbidity, OR 1.70 (1.55, 1.86). Total deaths recorded was n=8,175 [13.9%] which included 3,808 in-hospital and 4,367 post discharge. Mean time to death post-discharge was 24.1 months. Serum NT-proBNP ≥ 250 pg/ml was associated with increased mortality [OR 6.4, 95%CI: 5.6, 7.1]. Conclusion Elevated serum NT-proBNP at the time of hospital admission was a statistically significant prognostic indicator of 30 day and 9.5 year mortality in emergency medical admissions.
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Mckittrick et al. (2025) conducted an observational in Emergency medical admissions (n=58,439). Serum NT-proBNP ≥ 250 pg/ml vs. Serum NT-proBNP < 250 pg/ml was evaluated on Mortality (OR 6.4, 95% CI 5.6-7.1). Serum NT-proBNP ≥ 250 pg/ml at the time of emergency medical admission was significantly associated with increased mortality (OR 6.4; 95% CI 5.6-7.1).
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