Can NT-pro BNP Levels Predict Prognosis of Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in the Intensive Care Unit?

Abstract

Background: The prognostic value of amino terminal pro-brainnatriuretic peptide levels in patients with acute exacerbation ofchronic obstructive pulmonary disease has not been fully established.Aims: To investigate the predictive value of amino terminal pro-brainnatriuretic peptide levels in terms of mortality, need for noninvasivemechanical ventilation, invasive mechanical ventilation, and weaningsuccess.Study Design: Cohort study.Methods: Patients who were admitted to intensive care unit betweenDecember 2015 and December 2016 due to acute exacerbation ofchronic obstructive pulmonary disease were included in the study.Demographic data, noninvasive mechanical ventilation application,need for invasive mechanical ventilation, amino terminal pro-brainnatriuretic peptide level, duration of mechanical ventilation, intensivecare unit and hospital stay, weaning success, and mortality rates wererecorded.Results: A total of 110 patients (75 males) were included in the study.The mean age of the participants was 69 (61-76) years, and the meanAcute Physiology and Chronic Health Evaluation II score was 19 (15-23). The mean amino terminal pro-brain natriuretic peptide level wasfound to be lower in cases with noninvasive mechanical ventilationsuccess than those with noninvasive mechanical ventilation failure(p=0.053). In addition, the mean amino terminal pro-brain natriureticpeptide level was significantly higher (4740 pg/mL vs. 3004 pg/mL,p=0.001) in patients who needed invasive mechanical ventilationsupport than in patients who did not. The mortality rate wassignificantly higher in patients who had an increasing trend of aminoterminal pro-brain natriuretic peptide levels during hospitalizationthan in patients who had decreasing levels (59% vs. 23%, p=0.015).Based on the receiver operating characteristic analysis, the increasingtrend of amino terminal pro-brain natriuretic peptide levels duringintensive care unit stay predicted mortality with area under curveof 0.84 (p