Role of B-Type Natriuretic Peptide in Predicting In-Hospital Outcomes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease With Preserved Left Ventricular Function: A 5-Year Retrospective Analysis

Vallabhajosyula, Saraschandra; Haddad, Toufik Mahfood; Sundaragiri, Pranathi R.; Ahmed, Abdulla; Nawaz, Muhammad; Rayes, Hamza; Devineni, Harish; Kanmanthareddy, Arun; McCann, Dustin A.; Wichman, Christopher; Modrykamien, Ariel; Morrow, Lee E.

doi:10.1177/0885066616682232

Cited by 21 publications

(15 citation statements)

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“…25,33,35 Disease severity was also identified as a driver of ED visits, 35 and longer hospital or ICU stays. 38 These multivariate data support trends reported in other studies, captured both in this SLR and others in the broader literature. As an example, a cross-sectional survey conducted across France, Germany, Italy, Spain and the UK found that moderate-to-severe dyspnea was associated with a significant disease burden in patients with COPD, and was associated with significantly more frequent hospitalizations, specialist and physician consultations, LTOT use and pulmonary rehabilitation (all p<0.0001).…”

Section: Discussionsupporting

confidence: 89%

“…25 Factors independently associated with longer hospital stays for a COPD exacerbation were numerous and were reported in six studies. 31,32,[36][37][38][39] Drivers included the presence of comorbidities such as stroke 31 and some cardiac abnormalities, 31,32 advancing age and being female. 36 Furthermore, specific care-related factors such as a hospital's size, location or type were also found to be independent drivers of length of stay.…”

Section: Hrumentioning

confidence: 99%

“…32 Severe COPD (indicated by the use of home oxygen, oral/intravenous steroids, vasopressors or ventilation) and higher B-type natriuretic peptide levels were both found to be drivers of longer ICU stays. 38 Eight studies analyzed potential drivers of COPDrelated readmission to hospital for patients admitted with an exacerbation of COPD. [39][40][41][42][43][44][45][46] Among those that explored readmission for another exacerbation in the shorter term (within 30 days or within 2 months), history of coronary heart disease, 46 hospitalizations in the previous year 44 and baseline FEV 1 <30% predicted (vs ≥50% predicted) 43 were identified as independent drivers of increased readmission risk, but this is not an exhaustive summary.…”

Section: Hrumentioning

confidence: 99%

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<p>Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review</p>

Iheanacho¹,

Zhang

King

et al. 2020

COPD

232

130

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Background and Objectives: Chronic obstructive pulmonary disease (COPD) affects over 250 million people globally, carrying a notable economic burden. This systematic literature review aimed to highlight the economic burden associated with moderate-to-very severe COPD and to investigate key drivers of healthcare resource utilization (HRU), direct costs and indirect costs for this patient population. Materials and Methods: Relevant publications published between January 1, 2006 and November 14, 2016 were captured from the Embase, MEDLINE and MEDLINE In-Process databases. Supplemental searches from relevant 2015-2016 conferences were also performed. Titles and abstracts were reviewed by two independent researchers against predefined inclusion and exclusion criteria. Studies were grouped by the type of economic outcome presented (HRU or costs). Where possible, data were also grouped according to COPD severity and/or patient exacerbation history. Results: In total, 73 primary publications were included in this review: 66 reported HRU, 22 reported direct costs and one reported indirect costs. Most of the studies (94%) reported on data from either Europe or North America. Trends were noted across multiple studies for higher direct costs (including mean costs per patient per year and mean costs per exacerbation) being associated with increasingly severe COPD and/or a history of more frequent or severe exacerbations. Similar trends were noted according to COPD severity and/or exacerbation history for rate of hospitalization and primary care visits. Multivariate analyses were reported by 29 studies and demonstrated the statistical significance of these associations. Several other drivers of increased costs and HRU were highlighted for patients with moderate-to-very severe COPD, including comorbidities, and treatment history. Conclusion: Moderate-to-very severe COPD represents a considerable economic burden for healthcare providers despite the availability of efficacious treatments and comprehensive guidelines on their use. Further research is warranted to ensure cost-efficient COPD management, to improve treatments and ease budgetary pressures.

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Section: Discussionsupporting

confidence: 89%

Section: Hrumentioning

confidence: 99%

Section: Hrumentioning

confidence: 99%

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<p>Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review</p>

Iheanacho¹,

Zhang

King

et al. 2020

COPD

232

130

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“…Pulmonary pathology such as acute respiratory distress syndrome and chronic obstructive pulmonary disease and interventions such as mechanical ventilation influence the BNP levels in this population. 21,30 As noted in this metaanalysis, studies variably exclude preexisting chronic kidney disease and inconsistently adjust for acute kidney injury in their analyses. In patients with sepsis, studies have found conflicting results regarding correlations between BNP and serum creatinine levels.…”

Section: Discussionmentioning

confidence: 99%

“…15 In other critically ill patients with pulmonary embolism, chronic obstructive pulmonary disease, and congestive heart failure, BNP has been strongly associated with clinical outcomes and has been incorporated into risk stratification. [19][20][21] In patients with sepsis, however, there are conflicting data on the role of BNP/NT-proBNP as a risk-stratification and prognostication tool. Some investigators have considered BNP as a marker of severity, whereas others have reported it as an independent prognostic test.…”

mentioning

confidence: 99%

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

Vallabhajosyula

Wang

Murad

et al. 2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Data are conflicting regarding the optimal cutoffs of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) to predict short-term mortality in patients with sepsis. We conducted a comprehensive search of several databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus) for English-language reports of studies evaluating adult patients with sepsis, severe sepsis, and septic shock with BNP/NT-proBNP levels and short-term mortality (intensive care unit, in-hospital, 28-day, or 30-day) published from January 1, 2000, to September 5, 2017. The average values in survivors and nonsurvivors were used to estimate the receiver operating characteristic curve (ROC) using a parametric regression model. Thirty-five observational studies (3508 patients) were included (median age, 51-75 years; 12%-74% males; cumulative mortality, 34.2%). A BNP of 622 pg/mL had the greatest discrimination for mortality (sensitivity, 0.695 [95% CI, 0.659-0.729]; specificity, 0.907 [95% CI, 0.810-1.003]; area under the ROC, 0.766 [95% CI, 0.734-0.797]). An NT-proBNP of 4000 pg/mL had the greatest discrimination for mortality (sensitivity, 0.728 [95% CI, 0.703-0.753]; specificity, 0.789 [95% CI, 0.710-0.867]; area under the ROC, 0.787 [95% CI, 0.766-0.809]). In prespecified subgroup analyses, identified BNP/NT-proBNP cutoffs had higher discrimination if specimens were obtained 24 hours or less after admission, in patients with severe sepsis/ septic shock, in patients enrolled after 2010, and in studies performed in the United States and Europe. There was inconsistent adjustment for renal function. In this hypothesis-generating analysis, BNP and NT-proBNP cutoffs of 622 pg/mL and 4000 pg/mL optimally predicted short-term mortality in patients with sepsis. The applicability of these results is limited by the heterogeneity of included patient populations.

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Natriuretische Peptide in der Intensivmedizin

Großmann

Geisreiter

Schroll

2023

Med Klin Intensivmed Notfmed

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Role of B-Type Natriuretic Peptide in Predicting In-Hospital Outcomes in Acute Exacerbation of Chronic Obstructive Pulmonary Disease With Preserved Left Ventricular Function: A 5-Year Retrospective Analysis

Abstract: Elevated admission BNP in patients with AECOPD and normal LVEF is associated with worse in-hospital outcomes and can be used to risk-stratify these patients.

Cited by 21 publications

References 62 publications

<p>Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review</p>

<p>Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review</p>

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

Natriuretische Peptide in der Intensivmedizin

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