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. 2022 Feb 23:2022:5351137.
doi: 10.1155/2022/5351137. eCollection 2022.

Combination of Prehospital NT-proBNP with qSOFA and NEWS to Predict Sepsis and Sepsis-Related Mortality

Francisco Martín-Rodríguez  1   2 , Laura Melero-Guijarro  3 , Guillermo J Ortega  4 , Ancor Sanz-García  4 , Teresa de la Torre de Dios  5 , Jesús Álvarez Manzanares  6 , José L Martín-Conty  7 , Miguel A Castro Villamor  2 , Juan F Delgado Benito  1 , Raúl López-Izquierdo  6
Affiliations

Combination of Prehospital NT-proBNP with qSOFA and NEWS to Predict Sepsis and Sepsis-Related Mortality

Francisco Martín-Rodríguez et al. Dis Markers. .

Abstract

Background: The aim of this study was to assess the role of prehospital point-of-care N-terminal probrain natriuretic peptide to predict sepsis, septic shock, or in-hospital sepsis-related mortality.

Methods: A prospective, emergency medical service-delivered, prognostic, cohort study of adults evacuated by ambulance and admitted to emergency department between January 2020 and May 2021. The discriminative power of the predictive variable was assessed through a prediction model trained using the derivation cohort and evaluated by the area under the curve of the receiver operating characteristic on the validation cohort.

Results: A total of 1,360 patients were enrolled with medical disease in the study. The occurrence of sepsis, septic shock, and in-hospital sepsis-related mortality was 6.4% (67 cases), 4.2% (44 cases), and 6.1% (64 cases). Prehospital National Early Warning Score 2 had superior predictive validity than quick Sequential Organ Failure Assessment and N-terminal probrain natriuretic peptide for detecting sepsis and septic shock, but N-terminal probrain natriuretic peptide outperformed both scores in in-hospital sepsis-related mortality estimation. Application of N-terminal probrain natriuretic peptide to subgroups of the other two scores improved the identification of sepsis, septic shock, and sepsis-related mortality in the group of patients with low-risk scoring.

Conclusions: The incorporation of N-terminal probrain natriuretic peptide in prehospital care combined with already existing scores could improve the identification of sepsis, septic shock, and sepsis-related mortality.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Participant inclusion flow diagram.
Figure 2
Figure 2
Observed number of cases for each of the outcomes: (a) sepsis, (b) septic shock, and (c) mortality for NT-proBNP; (d) sepsis, (e) septic shock, and (f) mortality for NEWS; and (g) sepsis, (h) septic shock, and (i) mortality for qSOFA. The grey shadowed area shows the predicted probability of the outcome.
See this image and copyright information in PMC

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