Use of B‐type natriuretic peptide in the risk stratification of community‐acquired pneumonia

. Background.  Community‐acquired pneumonia (CAP) is the leading infectious cause of death in developed countries. Risk stratification has previously been difficult. Methods.  Markers of cardiac stress (B‐type natriuretic peptide, BNP) and inflammation (C‐reactive protein, white blood cell count, pr...

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Bibliographic Details
Published in:Journal of internal medicine 2008-08, Vol.264 (2), p.166-176
Main Authors: Christ‐Crain, M., Breidthardt, T., Stolz, D., Zobrist, K., Bingisser, R., Miedinger, D., Leuppi, J., Tamm, M., Mueller, B., Mueller, C.
Format: Article
Language:English
Subjects:
Aged
Area Under Curve
Biological and medical sciences
biomarker
Biomarkers - blood
C-Reactive Protein - metabolism
Calcitonin - metabolism
Calcitonin Gene-Related Peptide
Community-Acquired Infections - diagnosis
Community-Acquired Infections - mortality
Epidemiology
Female
Follow-Up Studies
General aspects
Humans
Leukocyte Count
Male
Medical sciences
mortality
Natriuretic Peptide, Brain - blood
Natriuretic Peptide, Brain - secretion
pneumonia
Pneumonia - diagnosis
Pneumonia - mortality
Predictive Value of Tests
Prognosis
Protein Precursors - metabolism
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Assessment - methods
Severity of Illness Index
Survival Analysis
Switzerland
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Summary:. Background.  Community‐acquired pneumonia (CAP) is the leading infectious cause of death in developed countries. Risk stratification has previously been difficult. Methods.  Markers of cardiac stress (B‐type natriuretic peptide, BNP) and inflammation (C‐reactive protein, white blood cell count, procalcitonin) as well as the pneumonia severity index (PSI) were determined in 302 consecutive patients presenting to the emergency department (ED) with CAP. The accuracy of these parameters to predict death was evaluated as the primary endpoint. Prediction of treatment failure was considered as the secondary endpoint. Results.  B‐type natriuretic peptide levels increased with rising disease severity as classified by the PSI (P = 0.015). BNP levels were significantly higher in nonsurvivors compared to survivors [median 439.2 (IQR 137.1–1384.6) vs. 114.3 (51.3–359.6) pg mL−1, P 
ISSN:0954-6820
1365-2796
DOI:10.1111/j.1365-2796.2008.01934.x