Tuberc Respir Dis.  2004 Jun;56(6):600-610. 10.4046/trd.2004.56.6.600.

Prognostic Role of B-type Natriuretic Peptide in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

• Lee JH
• Oh SY
• Hwang I
• Kim O
• Kim HK
• Kim EK
• Lee JH

• KMID: 1970466
• DOI: http://doi.org/10.4046/trd.2004.56.6.600

Abstract

BACKGROUND: The plasma B-type natriuretic peptide(BNP) concentration increases with the degree of pulmonary hypertension in patients with chronic respiratory disease. The aim of this study was to examine the prognostic role of BNP in the acute exacerbation of chronic obstructive lung disease (COPD). METHOD: We selected 67 patients who were admitted our hospital because of an acute exacerbation of COPD. Their BNP levels were checked on admission at the Emergency Department. Their medical records were analyzed retrospectively. The patients were divided into two groups according to their in-hospital mortality. The patients' medical history, comobidity, exacerbation type, blood gas analysis, pulmonary function, APACHE II severity score and plasma BNP level were compared.
RESULTS
Multiple logistic regression analysis identified three independent predictors of mortality: FEV1, APACHE II score and plasma BNP level. The decedents group showed a lower FEV1(28+/-7 vs. 37+/-15%, p=0.005), a higher APACHE II score(22.4+/-6.1 vs. 15.8+/-4.7, p=0.000) and a higher BNP level (201+/-116 vs. 77+/-80pg/mL, p=0.000) than the sSurvivors group. When the BNP cut-off level was set to 88pg/mL using the receiver operating characteristic curve, the sensitivity was 90% and the specificity was 75% in differentiating between the survivors and decedents. On Fisher's exact test, the odds ratio for mortality was 21.2 (95% CI 2.49 to 180.4) in the patients with a BNP level > 88pg/mL.
CONCLUSION
The plasma BNP level might be a predictor of mortality in an acute exacerbation of COPD as well as the FEV1 and APACHE II score.

Keyword

Chronic obstructive pulmonary disease; Acute exacerbation; B-type natriuretic peptide

MeSH Terms

APACHE
Blood Gas Analysis
Emergency Service, Hospital
Hospital Mortality
Humans
Hypertension, Pulmonary
Logistic Models
Medical Records
Mortality
Natriuretic Peptide, Brain*
Odds Ratio
Plasma
Pulmonary Disease, Chronic Obstructive*
Retrospective Studies
ROC Curve
Survivors
Natriuretic Peptide, Brain