Study on Serum N-terminal Pro-B-type Natriuretic Peptide Levels in Pneumonia and its Correlation with Confusion, Urea (Raised Blood Urea), Respiratory Rate (>30/min), Blood Pressure (Low), 65 (Age >65 Years) Score for Determining the Severity of Disease.

BACKGROUND AND AIM: An infection of the lung that mostly affects the alveolar space is known as pneumonia. According to the Global Burden of Disease Study, infection of the lower respiratory tract was the second most common cause of death and years of life lost. This study aims to study the serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in pneumonia as well as its correlation with Confusion, Urea (Raised blood urea), Respiratory rate (>30/min), Blood pressure (low), 65 (age >65 years) (CURB-65) score for determining the severity of disease.

MATERIALS AND

METHODS

An institution-based descriptive observational study with cross-sectional design was conducted in the Department of Medicine, RIMS, Ranchi, from October 2023 to September 2024. All adult patients aged 18 years and above were admitted with clinical and radiological signs of community-acquired pneumonia. Descriptive analysis was done in the form of proportion for categorical variables and median (interquartile range) and mean (standard deviation [SD]) for continuous variables. Continuous variables were checked for normal distribution, and nonparametric test (Mann-Whitney U test) was done accordingly. Spearman's correlation and Pearson correlation statistics was performed to assess the relationship between NT-proBNP and severity of the disease. The difference between proportions was analyzed using the Chi-square test, and P < 0.05 was considered statistically significant. Data were entered into MS Excel and analyzed using the SPSS version 20.

RESULTS

The study was conducted on 145 patients. The mean (SD) NT-proBNP level was 937.04 (1243.03) pg/ml. Around 11% of the patients expired during hospital stay and 89% were discharged. The respective mean NT proBNP level for the particular variable like patients with age >60, tobacco consumption, diabetes, hypertension, higher grades of the Modified Medical Research Council Scale for Dyspnoea (MMRC) and higher score of CURB 65 score was more than their counterparts. The mean NT-proBNP level was significantly higher among the patients expired during hospital stay than the patients who were discharged from the hospital. NT-proBNP was positively and significantly correlated with age, CURB-65 score, hospital stay, and MMRC grade with Spearman's correlation coefficient of 0.57, 0.83, 0.73, and 0.79, respectively.

CONCLUSION

The study demonstrated that levels of NT-proBNP positively correlated with CURB-65, MMRC grades, and mortality among the patients with pneumonia. Hence, NT-proBNP levels might be an effective parameter in predicting the disease course among the patients with pneumonia.