You Position: Home > Paper

Significance of early detection of N-terminal pro-B-type natriuretic peptide in patients with severe trauma

( views:387, downloads:44 )
Author:
No author available
Journal Title:
Chinese Journal of Emergency Medicine
Issue:
9
DOI:
10.3760/cma.j.issn.1671-0282.2011.09.017
Key Word:
严重创伤;N末端B型利钠肽原;预后;Major trauma;N-terminal pro-B-type natriuretic peptide;Prognosis

Abstract: Objective To detect the serum NT-proBNP level in patients with severe trauma 24 hours after injury in order to find the possible correlated factors for the evaluation of the clinical application.Methods Sixty patients with severe trauma admitted to the emergency ICU were enrolled. Serum NTproBNP level was detected 24 hours after injury for comparison between survivors and nonsurvivors. The validity of NT-proBNP for predicting outcome was analyzed by receiver operating characteristic ( ROC )curve. The factors with significant correlation between NT-proBNP level and the length of ICU stay as well as the duration of mechanical ventilation support were determined in those survivors with correlation and stepwise linear regression analysis. These factors included injury severity score (ISS), head abbreviated injury score (AIS), acute physiology and chronic health evaluation Ⅱ ( APACHE I ), Glasgow coma score (GCS), creatine kinase-MB (CK-MB), cardiac troponin-I (cTn-I) and central venous pressure. Results The median NT-proBNP levels were 762 pg/ml (IQR, 400-1131 pg/mL) in nonsurvivors versus 200 pg/ml (IQR, 80-383 pg/mL) in survivors (Z =-3. 972, P <0.01 ). The area under ROC curve of NTproBNP was not statistically different to that of ISS and that of APACHE Ⅱ. The best threshold value of NTproBN to predict the outcome was 384 pg/ml ( sensitivity 0. 846, specifity 0. 766). A positive correlation was found between NT-proBNP and the length of ICU stay ( r =0. 32, P < 0. 05 ) as well as the duration of mechanical ventilation ( r =0. 37, P < 0. 05 ) in survivors. Stepwise linear regression analysis indicated there were significant correlations between APACHE Ⅱ, CK-MB and NT-proBNP. Conclusions Serum NT-proBNP level 24 hours after injury is correlated with the severity and outcome of patients with severe trauma. It may be used as a complementary biomarker for the rapid assessment of the severity of trauma.

WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn