Yang Yong, Leng Jiahua, Chen Renxiong, Wang Hongzhi, Hao Chunyi
Department of Critical Care Medicine (ICU), Peking University Cancer Hospital & Institute, Beijing, China; Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China.
Gastrointestinal Cancer Center, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4214-4219. doi: 10.21037/apm-20-2212. Epub 2021 Mar 23.
This study aimed to examine the correlation between early brain natriuretic peptide (BNP) levels and mortality in cancer patients with septic shock.
A retrospective analysis of 159 cancer patients with septic shock admitted to the intensive care unit (ICU) from Dec. 2012 to Dec. 2019 was performed. BNP levels and other variables, including blood lactate (Lac), procalcitonin (PCT), white blood cell (WBC) counts, acute physiology and chronic health status system II scores (APACHE-II scores) were collected within 24 hours after ICU admission. According to 28-day mortality, patients were divided into a death group (60 cases) and a survival group (99 cases). All variables were compared by univariate analysis, and then a multiple logistic regression analysis was performed on the variables that showed significant differences. Receiver operating characteristic curve (ROC curve) analysis was used to evaluate the predictive value of BNP on mortality in cancer patients with septic shock.
BNP, APACHE-II score, Lac, and PCT in the death group were significantly higher than those in the survival group (P<0.05). Multiple logistic regression analysis of these four variables indicated that BNP, APACHE-II score and Lac were independent risk predictors of mortality in these patients (P<0.05). The BNP level at 899.6 pg/mL predicted mortality with a sensitivity of 76.7% and a specificity of 84.7%. The area under the ROC curve was 0.86±0.03 (P<0.05) for BNP, which was significantly larger than that of the APACHE-II score (P<0.05) and Lac (P<0.05).
BNP was an independent risk factor for mortality in cancer patients with septic shock, and had a higher predictive value than the APACHE-II score and Lac.
本研究旨在探讨癌症合并感染性休克患者早期脑钠肽(BNP)水平与死亡率之间的相关性。
对2012年12月至2019年12月入住重症监护病房(ICU)的159例癌症合并感染性休克患者进行回顾性分析。在患者入住ICU后24小时内收集BNP水平及其他变量,包括血乳酸(Lac)、降钙素原(PCT)、白细胞(WBC)计数、急性生理与慢性健康状况评分系统II(APACHE-II)评分。根据28天死亡率,将患者分为死亡组(60例)和存活组(99例)。对所有变量进行单因素分析,然后对显示出显著差异的变量进行多因素逻辑回归分析。采用受试者工作特征曲线(ROC曲线)分析评估BNP对癌症合并感染性休克患者死亡率的预测价值。
死亡组的BNP、APACHE-II评分、Lac和PCT显著高于存活组(P<0.05)。对这四个变量进行多因素逻辑回归分析表明,BNP、APACHE-II评分和Lac是这些患者死亡率的独立风险预测因素(P<0.05)。BNP水平为899.6 pg/mL时预测死亡率的敏感度为76.7%,特异度为84.7%。BNP的ROC曲线下面积为0.86±0.03(P<0.05),显著大于APACHE-II评分(P<0.05)和Lac(P<0.05)。
BNP是癌症合并感染性休克患者死亡率的独立危险因素,且比APACHE-II评分和Lac具有更高的预测价值。