Abstract

NAIDOO, A  and  DE VASCONCELLOS, K. The utility of brain natriuretic peptide as a prognosticating marker in critical care patients. South. Afr. j. crit. care (Online) [online]. 2023, vol.39, n.3, pp.90-95. ISSN 2078-676X.  http://dx.doi.org/10.7196/SAJCC.2023.v39i3.1218.

BACKGROUND. Brain natriuretic peptide (BNP) is an established biomarker of morbidity and mortality in cardiac failure. Data also suggest potential prognostic utility in non-heart failure cohorts. The utility of BNP in predicting intensive care unit (ICU) outcomes has not been well evaluated in a mixed critical care population in the South African (SA) context. OBJECTIVE. To evaluate the ability of BNP to predict ICU mortality in a heterogeneous critical care population in SA. METHODS. This was a retrospective observational study of 100 patients admitted to a multidisciplinary, closed, intensivist-run ICU in a tertiary academic hospital serving KwaZulu-Natal Province (1 January 2020 - 31 July 2022). Initial BNP was evaluated as a predictor of ICU mortality using univariate and multivariable analyses. RESULTS. There was a statistically significant difference in BNP between survivors and non-survivors in the cohort of patients without heart failure. The median initial BNP in the non-heart failure cohort was 411 (interquartile range (IQR) 116 - 848) ng/L in non-survivors, and 150 (44 - 356) ng/L in survivors (p=0.028). The optimal cut-off for BNP was determined as 366 ng/L. A BNP >366 ng/L was an independent predictor of ICU outcome. CONCLUSION. This study highlights the potential utility of BNP as a predictor of ICU mortality in a heterogeneous ICU population, with the greatest utility in patients without heart failure. Further studies are required to confirm this finding.

Keywords : Brain natriuretic peptide; ICU mortality; biomarker.

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