Brain natriuretic peptide for prediction of mortality in patients with sepsis: a systematic review and meta-analysis
Critical Care, 05/07/2012
Wang F et al. – The results suggested that an elevated BNP or N–terminal pro–B–type natriuretic peptide (NT–proBNP) level may prove to be a powerful predictor of mortality in septic patients.
PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched (up to February 18, 2011).
Studies were included if they had prospectively collected data on all–cause mortality in adult septic patients with either plasma BNP or NT–proBNP measurement.
Studies that failed to construct a 2 2 table of results were excluded.
Two authors independently determined the validity of included studies and extracted data.
12 studies with a total of 1,865 patients were included.
Elevated natriuretic peptides were significantly associated with increased risk of mortality (odds ratio (OR) 8.65, 95% confidence interval (CI) 4.94 to 15.13, P<0.00001).
The association was consistent for BNP (OR 10.44, 95% CI 4.99 to 21.58, P<0.00001) and NT–proBNP (OR 6.62, 95% CI 2.68 to 16.34, P<0.0001).
The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 79% (95% CI 75 to 83), 60% (95% CI 57 to 62), 2.27 (95% CI 1.83 to 2.81) and 0.32 (95% CI 0.22 to 0.46), respectively.
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