심정지 후 치료적 저체온 요법을 시행한 환자의 사망예측에 있어 B-type natriuretic peptide 수치의 유용성Serum B-type Natriuretic Peptide Levels for the Prediction of Death in Post-Cardiac Arrest Patients Treated with Therapeutic Hypothermia
- Other Titles
- Serum B-type Natriuretic Peptide Levels for the Prediction of Death in Post-Cardiac Arrest Patients Treated with Therapeutic Hypothermia
- Authors
- 안현철; 조진성; 김진주; 양혁준; 박원빈; 우재혁; 현성열; 임용수
- Issue Date
- Oct-2013
- Publisher
- 대한응급의학회
- Keywords
- Heart Arrest; Cardiopulmonary Resuscitation; Brain Natriuretic Peptide; Induced Hypothermia
- Citation
- 대한응급의학회지, v.24, no.5, pp.508 - 515
- Journal Title
- 대한응급의학회지
- Volume
- 24
- Number
- 5
- Start Page
- 508
- End Page
- 515
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/15267
- ISSN
- 1226-4334
- Abstract
- Purpose: Studies have demonstrated that B-type natriuretic peptide (BNP) has a predictive value for sudden cardiac arrest in heart failure patients. The aim of this study was to investigate the usefulness of serum BNP levels for theprediction of death in post-cardiac arrest patients treated withtherapeutic hypothermia (TH).
Methods: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between April 2007 and August 2010 were evaluated and divided into two groups based on death within 3 months. Initial serum BNP levels were checked and BNP levels compared between both groups.
Results: A total of 162 patients were enrolled in the study.
Among 162 patients, 109 patients were male (mean age of 50 years). The BNP levels of the non-survival group (n=77)were higher than those of the survival group (n=85); however,there was no statistical difference (19.45 pg/ml vs. 30.75pg/ml, p=0.174). The BNP cutoff value of 106 pg/ml for death within 3 months had a sensitivity of 35.1% and a specificity of 78.8%. In the logistic regression analysis, BNP levels higher than 106 pg/ml were significantly associated with death within 3 months (odds ratio [OR], 2.625; 95%confidence interval [CI], 1.066-6.463) and other independent factors were BLS to ROSC (OR, 1.105; CI, 0.082-1.038), non-VF/VT (OR, 3.698; CI, 1.632-8.380), and APACHE II score (OR, 1.117; CI, 1.035-1.204).
Conclusion: Initial Serum BNP levels are related with death within 3 months for patients that received TH after OHCA. However, additional randomized and controlled studies are needed.
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