Usefulness of Transthoracic Echocardiography Parameters and Brain Natriuretic Peptide as Mortality Predictors in Hospitalized Acutely Poisoned Patients: A Prospective Observational Study.

Acute poisonings represent a common cause of morbidity and mortality worldwide. The prognostic utility of the transthoracic echocardiography (TTE) parameters combined with brain natriuretic peptide (BNP) in acute poisoning with different xenobiotics, upon admission in the hospital, was not evaluated. This prospective observational cohort study included 229 acutely poisoned non-diabetic adults, with a median age of 44 years (range 18-90 years), 50.7% women, with an in-hospital mortality rate of 8.7%. Univariate logistic regression analysis showed that age, the left ventricle kinetic abnormalities, the E-wave deceleration time (EDT) and BNP correlated significantly with mortality in acutely poisoned patients. Multivariate logistic regression showed that only EDT [odds ratio (OR) 3.44, 95% confidence interval (CI) 1.54-7.69, p 0.003], BNP (OR 1.61, 95% CI: 1.02-2.55, p 0.04) and age (OR 2.66, 95% CI: 1.23-5.76, p 0.013) are predictive for mortality. The receiver-operating characteristic (ROC) analysis proved EDT [area under the ROC curve (AUC), 0.85; CI: 0.76-0.94; p 0.001], BNP (AUC, 0.83; CI: 0.75-0.91; p 0.001) and age (AUC, 0.82; CI: 0.74-0.90; p 0.001) as indicators for fatalities. In hospitalized patients acutely intoxicated with undifferentiated poisons, EDT as a parameter of left ventricle diastolic function and BNP are useful to early predict mortality.