N-terminal pro-BNP predicts mortality better than procalcitonin in abdominal severe sepsis and septic shock

Introduction

N-terminal pro-BNP (pBNP) could be useful to predict outcome in severe sepsis. We have conducted a study to compare pBNP and procalcitonin (PCT) in the setting of abdominal severe sepsis or septic shock.

Methods

We performed a prospective study of 51 consecutive patients with abdominal severe sepsis or septic shock. Age, gender, APACHE II score at admission, in-unit survival, presence of septic shock and serum PCT and pBNP levels during 4 days after admission were determined. Statistics: chi-square test, Student's t test, Mann-Whitney's test for samples without normal distribution and Cox's logistic regression. P < 0.05 was considered statistically significant.

Results

The mean APACHE II score at admission was 20.52 ± 5.07. This value was found to be significantly higher in nonsurvivors (18.38 ± 4.56 vs. 24.00 ± 4.03, P < 0.05). Values of pBNP were significantly higher in nonsurvivors from the first day of the study. PCT levels were higher in nonsurvivors, but only reached statistically significance on day 2 (Table 1). These results were not found to be influenced by age, gender or presence of shock in multivariate analysis.

Table 1 Values of pBNP and PCT during the study period

Conclusions

Our results shown that pBNP could be more useful than PCT to discriminate the patients with abdominal severe sepsis and worse outcome.