Key result
Serum NT-proBNP predicts 28-day PICU mortality with ~0.71 AUC but lacks independent predictive value.
Why the study?
The clinical value of serum NT-proBNP in evaluating and predicting outcomes in critically ill pediatric patients in the PICU was not well established.
Does serum NT-proBNP level predict 28-day mortality in critically ill children in the PICU?
Observational (n=375)
Does serum NT-proBNP level predict 28-day mortality in critically ill children in the PICU?
While higher NT-proBNP levels correlate with illness severity in the PICU, they are not an independent predictor of 28-day mortality.
Answers are grounded in this paper and cite their sources.
NT-proBNP should not yet guide PICU mortality risk assessment; hypothesis-generating for severity correlation in larger prospective studies.
BACKGROUND: N-terminal brain natriuretic peptide precursor (NT-proBNP) and brain natriuretic peptide (BNP) are mainly produced and secreted in the heart. In 2008, the European Heart Association recommended that serum BNP/NT-proBNP levels should be included in one of the diagnostic criteria of heart failure. Serum NT-proBNP is more stable than BNP, and the detection results are less affected by objective factors, so it is widely used. At present, NT-proBNP has long been beyond the scope of heart failure markers, and has a wide range of clinical value in the evaluation and prediction of some serious diseases. This study prospectively studied the predictive value of serum NT-proBNP in pediatric intensive care unit (PICU). METHODS: This was a prospective study involving 375 children in the PICU. The patients were divided into three groups: non-risk, low-risk, and high-risk groups. Serum NT-proBNP levels and the 28-day mortality rate were analyzed. RESULTS: The serum NT-proBNP levels and the mortality of the high-risk group was significantly higher than those of the low- and non-risk groups (P<0.01 in both cases). Receiver operating characteristic curve (ROC curve) analysis showed that the area under the curve was 0.705 (P<0.001, sensitivity =0.643, specificity =0.692). Death multivariate binary logistic regression analysis indicated that NT-proBNP was not an independent factor for 28-day mortality. CONCLUSIONS: Serum NT-proBNP was significantly correlated with the severity of illness for critically ill patients in PICU. Although high levels of NT-proBNP indicated greater severity, this was not an independent risk factor affecting the prognosis of patients.
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Liu et al. (2021) conducted an observational in Critically ill patients in pediatric intensive care unit (n=375). Serum NT-proBNP levels vs. Low-risk and non-risk groups was evaluated on 28-day mortality (AUC 0.705, p=<0.001). Serum NT-proBNP levels correlated with illness severity and predicted 28-day mortality with an AUC of 0.705, but were not an independent risk factor for mortality in PICU patients.
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