Female-Specific Association of Plasma N-Terminal Pro-Brain Natriuretic Peptide With Organ Dysfunction and Prognosis in Sepsis: A Retrospective Study

Shuangyi Yin; Yijie Zhang; Yu Guo; Qing Bai; Zhibo Lu; Na Chen; Edmund J Miller; Wei Li

doi:10.1097/CCE.0000000000000392

Female-Specific Association of Plasma N-Terminal Pro-Brain Natriuretic Peptide With Organ Dysfunction and Prognosis in Sepsis: A Retrospective Study

Crit Care Explor. 2021 May 12;3(5):e0392. doi: 10.1097/CCE.0000000000000392. eCollection 2021 May.

Authors

Shuangyi Yin¹, Yijie Zhang¹, Yu Guo¹, Qing Bai¹, Zhibo Lu¹, Na Chen², Edmund J Miller³, Wei Li¹

Affiliations

¹ Sepsis Laboratory, Center for Translational Medicine, Huaihe Hospital, Henan University, Henan, China.
² Department of Pulmonary and Critical Care Medicine, Huaihe Hospital, Henan University, Henan, China.
³ RDS2 Solutions, 25 Health Sciences Drive, Stony Brook, NY.

Abstract

Objectives: The plasma level of N-terminal pro-brain natriuretic peptide is regulated by sex hormones. It has been controversial whether N-terminal pro-brain natriuretic peptide is a prognosis marker for sepsis. The aim of this study is to examine the sex-dependent association of plasma N-terminal pro-brain natriuretic peptide with organ dysfunction and mortality of sepsis patients.

Design: In this retrospective study, the association between plasma N-terminal pro-brain natriuretic peptide concentration on the day of sepsis diagnosis and the degree of organ dysfunction, occurrence of septic shock, or 30-day mortality in both male and female patients was analyzed.

Setting: This study was conducted in the Sepsis Laboratory at the Huaihe Hospital of Henan University in China.

Patients: Diagnoses of sepsis, and septic shock, were based on the recently revised criteria (Sepsis 3.0). All sepsis patients (517) hospitalized in the respiratory ICU of the Huaihe Hospital from June 2016 to December 2019 were enrolled in this study.

Interventions: None.

Measurements and main results: No significant difference was found in the age, occurrence rate of septic shock, 30-day mortality, or degree of organ dysfunction between male and female patients. Median concentration of plasma N-terminal pro-brain Natriuretic peptide was higher by 93.48% in female than male patients. A significant association was found between N-terminal pro-brain natriuretic peptide and septic shock or 30-day mortality in female, but not in male patients of community- or hospital-acquired sepsis. N-terminal pro-brain natriuretic peptide levels correlated to functional deficiencies of the cardiac and nervous systems, only in female patients.

Conclusions: The plasma N-terminal pro-brain natriuretic peptide level is a female-specific prognosis indicator of septic shock and mortality.

Keywords: N-terminal pro-brain natriuretic peptide; female-specific; mortality; organ dysfunction; prognostic marker; sepsis; septic shock.