Serum brain natriuretic peptide levels in community acquired pneumonia and its comparison with CURB-65: A case series study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3902-3908
AbstractBackground and Objectives: Community-acquired pneumonia (CAP) is the leading infectious cause of death in developed countries and remains the sixth most common overall cause of death1. The clinical prognostic indices like pneumonia severity index (PSI) and CURB-65 have stood the test of time and are still being used in developing countries. But these are cumbersome and the observations may be examiner dependent. There arose a need for a reliable and quick laboratory-based index which could help in triaging the patient. Various inflammatory markers like CRP, Procalcitonin have been analyzed as potential candidates for triage because of the concept that the clinical severity of pneumonia is proportional to the inflammatory response. One important factor that could determine the severity is the extent of myocardial involvement. Hence the cardiac biomarkers were used in assessing the severity of pneumonia. The most useful of them are the natriuretic peptides and the most measurable of these peptides were BNP and NT- Pro BNP.
Aims and Objectives:
1. To estimate serum BNP levels in patients diagnosed with community acquired pneumonia
2. To analyze whether elevated BNP levels correlate with a higher mortality rate and a clinically severe disease as measured by the morbidity and outcomes.
3. To compare serum BNP levels with CURB-65 score in predicting the clinical severity and mortality in pneumonia.
Methods: It is A case series study. The entire study was done on patients who was admitted under the care of department of general Medicine, SNMC and HSK Hospital Bagalkot. The study was conducted for a period of 1year 6months from January 2020 to June 2021. A total of 60 cases were studied.
Results: Total of 60 persons are involved in the study among them 41 were male (68.3%) and 19(31.7%) were female. The prime aim of the study was to assess the ability of BNP to predict poor outcomes including death in a patient with pneumonia. The study showed that the mean BNP value in non-survivors was (570 pg/ml) significantly higher than that (335.5 pg/ml) in survivors with a P value of 0.014. Values of more than 200 pg/ml was usually associated with clinically severe disease and values more than 400pg/ml are associated with a higher rate of mortality. 7 patients were expired in age group >65 years and 3 patients were expired in age group 65 years old and 30% were 65 years old. S.pneumonia isolated in 15% of study population, S.aureus and klebsiella pneumonia isolated in 10% of study population H.influenza and pseudomonas were isolated in 7% of study population.no organisms isolated in 40% of study population.
Conclusion: The inferences that this study brought about were
1. Assessing the BNP levels on admission is a rapid and reliable means triaging pneumonia patients into various levels of care.
2. A high BNP level on admission is an independent risk factor for high mortality and morbidity in patients with pneumonia.
3. BNP levels correlated with the clinical severity of the disease.
4. BNP levels may be as effective as or better than CURB-65 score in predicting the disease course.
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