• Am J Emerg Med · Dec 2024

    Brain natriuretic peptide as a predictor of 30-day mortality after return of spontaneous circulation in cardiac arrest patients.

    • Xiaxia Jin, Qiaofei Zheng, Ying Cheng, Lingling Hu, Wenhui Yang, Jun Li, and Tao Li.
    • Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.
    • Am J Emerg Med. 2024 Dec 1; 86: 879387-93.

    PurposeTo determine the predictive value of brain natriuretic peptide (BNP) levels for 30-day mortality after return of spontaneous circulation (ROSC) in patients with cardiac arrest (CA) of presumed cardiac etiology.MethodsThis retrospective study included 260 patients with CA of presumed cardiac etiology who regained ROSC and was conducted between November 2013 and June 2022 at two tertiary comprehensive hospitals. Cox regression and nomogram models were used to demonstrate the value of BNP level in predicting 30-day mortality rates. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to compare the ability of the two models to predict 30-day mortality risk.ResultsBNP level was a predictive factor for 30-day mortality (hazard ratio [HR] = 1.441; 95 % confidence interval [CI] = 1.198-1.734). The area under curves (AUCs) of BNP level alone and model 2 (male sex, age, non-shockable rhythm, epinephrine, and time to ROSC >30 min) for predicting 30-day mortality were similar(0.813 versus 0.834). Model 1 that included the variables in model 2 and BNP level showed good predictive value (area under curve = 0.887; 95 % CI = 0.836-0.939). Compared to Model 2, Model 1 showed improved comprehensive differentiation and net weight classification of mortality prediction, further demonstrating the predictive value of BNP for 30-day mortality (NRI = 0.451, 95 % CI = 0.267-0.577; IDI = 0.109, 95 % CI = 0.035-0.191).ConclusionBNP level was a predictive factor for 30-day mortality after ROSC in patients with CA of presumed cardiac etiology who regained ROSC. The nomogram model included BNP may provide a reference for predicting 30-day mortality.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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