記述言語：英語   掲載種別：研究論文（学術雑誌）  

Serum N-terminal pro-brain-type natriuretic peptide (NT-proBNP) and brain-type natriuretic peptide (BNP) levels are rarely evaluated simultaneously in patients requiring intensive care.A total of 4,724 patients were screened, and 1,755 patients with BNP levels < 100 pg/mL were analyzed. Patients were divided into two groups, according to the median value of the NT-proBNP/BNP ratio (low-NT-proBNP/BNP group [Group L] versus high-NT-proBNP/BNP group [Group H]). A multivariate logistic regression model showed that the C-reactive protein levels (per 1-mg/dL increase) and serum creatinine levels (per 1-mg/dL increase) were independently associated with a high NT-proBNP/BNP ratio (odds ratio: 1.251, 95% confidence interval [95% CI]: 1.172-1.335 and odds ratio: 1.941, 95% CI: 1.468-2.567, respectively). The Kaplan-Meier curve analysis showed that the prognosis was significantly poorer in Group H than in Group L. Moreover, a multivariate Cox regression model revealed that a high NT-proBNP/BNP ratio was an independent predictor of 365-day mortality (hazard ratio: 1.468, 95% CI: 1.027-2.067). The same significant trend in prognostic impact was observed in the low-creatinine (< 0.83 mg/dL, n = 883), high-creatinine (≥ 0.83 ng/dL, n = 872), and high- C-reactive protein (≥ 0.16 mg/dL, n = 842) cohorts.A high NT-proBNP/BNP ratio was associated with a non-cardiac condition. Consequently, it was independently associated with adverse outcomes in patients requiring intensive care, even in those with a low BNP value on admission.

DOI： 10.1536/ihj.24-702

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The aim of the present study is to elucidate prognostic impact of temporal trends of non-surgical patients requiring intensive care over a 10-year period. METHODS AND RESULTS: A total of 4276 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled. Patients' backgrounds, in-hospital management, and prognoses were compared between five groups [2012-2013 (n = 825), 2014-2015 (n = 784), 2016-2017 (n = 864), 2018-2019 (n = 939), and 2020-2021 (n = 867)]. During the study period, mean age significantly increased from 69 years in 2012-2013 to 72 years in 2020-2021. Mean Acute Physiology and Chronic Health Evaluation scores significantly increased from 10 points in 2012-2013 to 12 points in 2020-2021. The median duration of intensive care unit stays increased from 3 to 4 days. Kaplan-Meier survival curve analysis showed that survival rates during 30- and 365-days were significantly lower in 2020-2021 than in 2012-2013, but it was not significantly different by a Cox proportional hazards regression model in 30 days. A Cox proportional hazards regression model revealed that the risks of 365-day all-cause death were significantly higher in patients enrolled in 2016-2017 (HR: 1.324, 95 % CI: 1.042-1.680, p = 0.021), in 2018-2019 (HR: 1.329, 95 % CI: 1.044-1.691, p = 0.021), and in 2020-2021 (HR: 1.409, 95 % CI: 1.115-1.779, p = 0.004). CONCLUSION: The condition of patients requiring intensive care is becoming more critical year by year, leading to poorer long-term prognoses despite improvements in treatment strategies. These findings emphasize the importance of additional care management after admission into non-surgical intensive care units, particularly for the aging society of Japan.

DOI： 10.1016/j.jjcc.2024.06.003

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記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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記述言語：英語   出版者・発行元：(一社)日本心血管インターベンション治療学会  

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記述言語：日本語   出版者・発行元：日本内科学会-関東地方会  

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