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.

Methods

  • 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.

Results

  • 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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