الفهرس 
SepsisOnly 14 pages are availabe for public view
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Abstract
Objective: N-terminal pro-BNP (NTproBNP) and CRP could be useful to predict outcome in severe sepsis and septic shock. We have conducted a study to evaluate NTproBNP and CRP levels in the setting of severe sepsis and septic shock.
Methodology: Fifty patients with severe sepsis or septic shock were involved in a prospective randomized clinical study (mean age was 49.6 ± 17.7 yrs, 64% female), were divided into 2 groups according to mortality and were subjected to assessment by scoring system (APACHE II & SOFA), laboratory measurement of the mentioned sepsis biomarkers (NT-proBNP&CRP) after 24 hours of ICU admission.
Results: Mortality rate was 38%, SOFA score in non survivors was significantly elevated (9.7±2.8 vs 6.5±2.6, p value: <0.001). APACHEII score in non survivors was significantly elevated (26.3±6.0 vs 17.9±4.5 .p value: <0.001). Sepsis biomarkers (NT-proBNP and CRP levels) were found to be elevated on ICU admission. NTBNP level had a mean value of 3798.9 ± 2347.5 pg/ml, serum CRP had a mean value of 53.2 ± 33.2 mg/dl. NT-proBNP level in non survivors was significantly elevated (4619.6 ± 2118.1 vs 2328.2 ± 2061.0 pg/ml, p value: <0.001), CRP level in non survivors was significantly elevated (67.3±32.0 vs 44.5±31.3 mg/dl, p value: 0.02).There were significant strong positive correlations between serum NTPNB levels with both APACHEII score (r. 0.74 & p. <0.001) and SOFA score (r. 0.62 & p. 0.00).There were significant strong positive correlation between serum NTPNB levels with serum CRP levels (r. 0.52 & p. <0.001) NTproBNP had a cutoff point of 3045.0 pg/ml where AUC was 0.85, P; <0.001, sensitivity 89.5 %, specificity 77.4 %. CRP had a cutoff point of 36.0 mg/dl where AUC was 0.69, P; 0.027, sensitivity 78.9 % & specificity 48.4 %.
Conclusions: NT-proBNP and CRP values are frequently increased in severe sepsis and septic shock. Values are significantly higher in nonsurvivors than survivors. NT-proBNP on admission day in the intensive care unit is an independent prognostic marker of mortality in severe sepsis