• Regev Landau, Ana Belkin, Sapir Kon-Kfir, Nira Koren-Morag, Avishay Grupper, David Shimunov, Ben-Ami Sela, Ehud Grossman, Gadi Shlomai, and Avshalom Leibowitz.
• Department of Internal Medicine D.
• Isr Med Assoc J. 2022 Nov 1; 24 (11): 713718713-718.

BackgroundMost dyspneic patients in internal medicine departments have co-morbidities that interfere with the clinical diagnosis. The role of brain natriuretic peptide (BNP) levels is well-established in the acute setting but not in hospitalized patients.ObjectivesTo evaluate the additive value of BNP tests in patients with dyspnea admitted to medical wards who did not respond to initial treatment.MethodsWe searched the records of patients who were hospitalized in the department of internal medicine D at Sheba Medical Center during 2012 and were tested for BNP in the ward. Data collected included co-morbidity, medical treatments, diagnosis at presentation and discharge, lab results including BNP, re-hospitalization, and mortality at one year following hospitalization.ResultsBNP results were found for 169 patients. BNP was taken 1.7 ± 2.7 days after hospitalization. According to BNP levels, dividing the patients into tertiles revealed three equally distributed groups with a distinctive character. The higher tertile was associated with higher rates of cardiac co-morbidities, including heart failure, but not chronic obstructive pulmonary disease. Higher BNP levels were related to one-year re-hospitalization and mortality. In addition, higher BNP levels were associated with higher rates of in-admission diagnosis change.ConclusionsBNP levels during hospitalization in internal medicine wards are significantly related to cardiac illness, the existence of heart failure, and patient prognosis. Thus, BNP can be a useful tool in managing dyspneic patients in this setting.

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