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Báo cáo y học: "Usefulness of N-terminal pro-brain natriuretic peptide and C-reactive protein to predict ICU mortality in unselected medical ICU patients: a prospective, observational study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Usefulness of N-terminal pro-brain natriuretic peptide and C-reactive protein to predict ICU mortality in unselected medical ICU patients: a prospective, observational study. | Wang et al. Critical Care 2011 15 R42 http ccforum.eom content 15 1 R42 KS CRITICAL CARE RESEARCH Open Access Usefulness of N-terminal pro-brain natriuretic peptide and C-reactive protein to predict ICU mortality in unselected medical ICU patients a prospective observational study Feilong WangC Wenzhi Pan2t Shuming Pan1 Shuyun Wang1 Qinmin Ge1 Junbo Ge2 Abstract Introduction The performance of N-terminal pro-brain natriuretic peptide NT-proBNP and C-reactive protein CRP to predict clinical outcomes in ICU patients is unimpressive. We aimed to assess the prognostic value of NT-proBNP CRP or the combination of both in unselected medical ICU patients. Methods A total of 576 consecutive patients were screened for eligibility and followed up during the ICU stay. We collected each patient s baseline characteristics including the Acute Physiology and Chronic Health Evaluation II APACHE-II score NT-proBNP and CRP levels. The primary outcome was ICU mortality. Potential predictors were analyzed for possible association with outcomes. We also evaluated the ability of NT-proBNP and CRP additive to APACHE-II score to predict ICU mortality by calculation of C-index net reclassification improvement NRI and integrated discrimination improvement IDI indices. Results Multiple regression revealed that CRP NT-proBNP APACHE-II score and fasting plasma glucose independently predicted ICU mortality all P 0.01 . The C-index with respect to prediction of ICU mortality of APACHE II score 0.82 0.02 P 0.01 was greater than that of NT-proBNP 0.71 0.03 P 0.01 or CRP 0.65 0.03 P 0.01 all P 0.01 . As compared with APACHE-II score 0.82 0.02 P 0.01 combination of CRP 0.83 0.02 P 0.01 or NT-proBNP 0.83 0.02 P 0.01 or both 0.84 0.02 P 0.01 with APACHE-II score did not significantly increase C-index for predicting ICU mortality all P 0.05 . However addition of NT-proBNP to aPaCHE-II score gave IDI of 6.6 P 0.003 and NRI of 16.6 P 0.007 addition of CRP to APACHE-II score provided IDI of 5.6 P 0.026 .