ISSN : 2146-3123
E-ISSN : 2146-3131

Can nT-proBNP Levels Predict Prognosis of Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in the Intensive Care Unit?
Özlem Ediboğlu1, Cenk Kıraklı1
1Clinic of Pulmonology, University of Health Sciences, Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
DOI : 10.4274/balkanmedj.2018.0006

Background: Prognostic value of nT-proBNP levels in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) has not been fully established.
Aims: We aimed to investigate the predictive value of nT-proBNP levels in terms of mortality, the need for noninvasive mechanical ventilation (NIV), invasive mechanical ventilation (IMV) and weaning success in this study.
Study Design: Retrospective cohort.
Methods: Patients who were admitted to ICU between December 2015 and December 2016 due to acute exacerbation of COPD (AECOPD) were included into the study. Demographic data, NIV application, the need for IMV, nT-proBNP level, duration of mechanical ventilation, ICU and hospital stay, weaning success and mortality rates were recorded.
Results: A total of 110 patients (75 males) were included in the study. Mean age was 69 (61-76) years and mean APACHE II score was 19 (15-23). Mean nT-proBNP level was found to be lower in the cases with NIV success than those with NIV failure (p = 0.053). In addition, mean nT-proBNP level was significantly higher (4740 pg / ml vs. 3004 pg / ml, p = 0.001) in patients who needed IMV support than in the patients who did not. Mortality was significantly higher in patients who exhibited an increasing trend of nT- proBNP levels during hospitalization than in patients whose levels decreased (59% vs. 23%, p = 0.015). On ROC analysis, the increased trend in nT- proBNP levels during ICU stay predicted mortality with AUC of 0,84 (p<0.0001, 95% CI:0,75- 0,93) and predicted IMV need with AUC of 0,68.
Conclusion: In cases of AECOPD requiring mechanical ventilation, nT- proBNP measurement and monitoring of the trend may be a valuable asset in predicting mortality, NIV and weaning success and the need for IMV.

Keywords : Chronic obstructive pulmonary disease, mortality, nT-proBNP
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