Brain natriuretic peptide as a predictive marker of mortality in sepsis: an updated systematic review and meta-analysis.


Journal

BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535

Informations de publication

Date de publication:
07 Aug 2024
Historique:
received: 22 06 2024
accepted: 29 07 2024
medline: 8 8 2024
pubmed: 8 8 2024
entrez: 7 8 2024
Statut: epublish

Résumé

Early identification of patients with sepsis at high risk of death remains a challenge, and whether brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) has a prognostic effect on patients with sepsis is controversial. Here, we clarified the prognostic value of BNP and NT-proBNP and sought to establish suitable cutoff values and intervals. We searched five databases to identify studies that met the inclusion criteria. The primary outcomes were the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and corresponding 95% credible interval (95% CI) of BNP and NT-proBNP. The secondary outcomes were the sensitivity and specificity of BNP or NT-proBNP in subgroup analyses. Forty-seven studies were included in our meta-analysis. The pooled sensitivity of NT-proBNP (0.77 [0.68, 0.84]) was weaker than that of BNP (0.82 [0.76, 0.87]), the pooled specificity of NT-proBNP (0.70 [0.60, 0.77]) was less than that of BNP (0.77 [0.71, 0.82]), and the AUC of BNP (0.87 [0.83-0.89]) was greater than that of NT-proBNP (0.80 (0.76-0.83]). The results of the subgroup analysis showed that the cutoff range of 400-800 pg/mL for BNP had high sensitivity (0.86 [0.74-0.98]) and specificity (0.87 [0.81-0.93]) and was probably the most appropriate cutoff range. Elevated levels of BNP and NT-proBNP were significantly related to the mortality of patients with sepsis and had a moderate prognostic value in predicting the mortality of patients with sepsis. In addition, our meta-analysis preliminarily established appropriate cutoff values for BNP and NT-proBNP.

Identifiants

pubmed: 39112946
doi: 10.1186/s12871-024-02661-z
pii: 10.1186/s12871-024-02661-z
doi:

Substances chimiques

Natriuretic Peptide, Brain 114471-18-0
Biomarkers 0
Peptide Fragments 0
pro-brain natriuretic peptide (1-76) 0

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

276

Subventions

Organisme : Sichuan Key Clinical Specialty project
ID : 2022-16
Organisme : Sichuan Key Clinical Specialty project
ID : 2022-16
Organisme : Sichuan Key Clinical Specialty project
ID : 2022-16
Organisme : Sichuan Key Clinical Specialty project
ID : 2022-16
Organisme : Sichuan Key Clinical Specialty project
ID : 2022-16
Organisme : Sichuan Key Clinical Specialty project
ID : 2022-16

Informations de copyright

© 2024. The Author(s).

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Auteurs

Jian-Li Song (JL)

Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, People's Republic of China.

Bin Fan (B)

Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, People's Republic of China.

Li-Quan Qiu (LQ)

Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, People's Republic of China.

Qiang Li (Q)

Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, People's Republic of China.

Guan-Yu Chen (GY)

Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, People's Republic of China. 741755319@qq.com.

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