B-type natriuretic peptide as a predictor of severity in admitted patients with acute exacerbation of COPD

Abstract

Background patients with acute AECOPD show an abrupt worsening of baseline ventricular function and pulmonary hypertension, using clear predictors or markers for severity in such patients is critical to be early stratified and properly managed. Aim Assess the value of BNP as A predictor for severity in patients with AECOPD represented by need for intensive care admission, invasive and non-invasive mechanical ventilation, pulmonary hypertension, hospital and 3 months mortality. Study design Prospective study Methods A prospective Cohort study in tertiary level hospital conducted on 88 patients with AECOPD and 88 healthy control subjects, patients were divided into 2 subgroups: ICU admitted and ward admitted Patient were subjected to clinical, electrocardiographic, radiological and laboratory evaluation and observation of the clinical course during admission and 3 months following hospital discharge. Results The study revealed higher BNP in AECOPD patients compared with healthy control subjects and in ICU admitted compared with ward patients (P, 0.001). positive correlation with age, smoking index, Paco2, SPAP, RVD, need for ICU ,IMV, hospital stay and overall Mortality (r.coefficient: 0.398, 0.533, 0.605, 0.635, 0.732, -0.617, 0.577, 0.728 0.030, respectivly) ,we revealed negative correlation with ABGs parameters (Pao2, PH and o2 saturation), with r. coefficient of (-0.616, -0.609, -0.630, respectively), linear regression revelled that BNP is significant predictors for ICU admission ,ROC curve revealed that BNP more than 425pg/ml had sensitivity , specificity of (70.8% and, 100%) to predict need for ICU admission. Conclusion BNP may be considered as an accessible, useful, non-invasive and low-cost marker of severity COPD exacerbations.