Investigation of the predictive value of NT-proBNP on cardiovascular failure and mortality in patients with sepsis and septic shock admitting to the emergency department

Investigation of the Predictive Value of NT-proBNP on Cardiovascular Failure and Mortality in Patients With Sepsis and Septic Shock Admitting to the Emergency Department Introduction and aim: In this study, we investigated whether the use of NT-proBNP in patients with a diagnosis of sepsis admitted to the emergency department is useful in predicting mortality and the development of sepsis-related cardiovascular failure. We think that this study will be beneficial for emergency service workers in the diagnosis ofsepsis patients and early treatment planning. Material and methods: In this study, 175 patients without heart failure who were diagnosed with sepsis and septic shock over the age of 18 in the Emergency Medicine Department of İnönü University Faculty of Medicine between 1st July 2021 and 31st July 2022 were prospectively investigated. Results: The 28th day mortality rate of the patients with sepsis and septic shock included in the study was 35% (60 cases) and their in-hospital mortality was 42% (73 cases). The cut-off value was calculated as >4049 pg/ml, according to the ROC curve analysis of the mean NT-proBNP level at the time of admission to the emergency department to predict mortality in patients with sepsis. Again, the cut-off value of the mean NT-proBNP level at the time of admission to the emergency department to predict the development of cardiovascular failure was found to be >4049 pg/ml according to the ROC curve analysis. According to Kaplan Meier survival analysis results, it was determined that patients with NT-proBNP value ≥4049 had shorter mean hospital survival and 28-day survival times than patients with NT-proBNP value ˂4049. In the Cox regression analysis, which affects hospital mortality and 28-day mortality, it was determined that the presence of NT-proBNP increased the in-hospital mortality 2.67 times, while high NT-proBNP increased the risk of 28-day mortality 2.78 times. Conclusion: Different levels of NT-proBNP have been observed to increase in patients with sepsis and septic shock. The level of NT-proBNP was found to be high in patients who developed cardiovascular failure and died. It has also been found to increase the risk of hospital mortality and 28-day mortality. NT-proBNP can be used as a predictor of heart failure due to sepsis and as a poor prognostic indicator of sepsis. However, extensive prospective studies are needed to investigate the role of NT-proBNP in the early diagnosis and prognosis of sepsis patients. Keywords: Emergency department, NT-proBNP, cardiovascular failure, mortality