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Usefulness of Transthoracic Echocardiography Parameters and Brain Natriuretic Peptide as Mortality Predictors in Hospitalized Acutely Poisoned Patients: A Prospective Observational Study
Author(s) -
Lionte Catalina,
Sorodoc Victorita,
Bologa Cristina,
Tuchilus Cristina,
Jaba Elisabeta
Publication year - 2017
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12711
Subject(s) - medicine , brain natriuretic peptide , confidence interval , logistic regression , cardiology , receiver operating characteristic , prospective cohort study , odds ratio , area under the curve , univariate analysis , natriuretic peptide , ventricle , observational study , multivariate analysis , heart failure
Acute poisonings represent a common cause of morbidity and mortality worldwide. The prognostic utility of the transthoracic echocardiography (TTE) parameters combined with brain natriuretic peptide (BNP) in acute poisoning with different xenobiotics, upon admission in the hospital, was not evaluated. This prospective observational cohort study included 229 acutely poisoned non‐diabetic adults, with a median age of 44 years (range 18–90 years), 50.7% women, with an in‐hospital mortality rate of 8.7%. Univariate logistic regression analysis showed that age, the left ventricle kinetic abnormalities, the E‐wave deceleration time (EDT) and BNP correlated significantly with mortality in acutely poisoned patients. Multivariate logistic regression showed that only EDT [odds ratio (OR) 3.44, 95% confidence interval (CI) 1.54–7.69, p 0.003], BNP (OR 1.61, 95% CI: 1.02–2.55, p 0.04) and age (OR 2.66, 95% CI: 1.23–5.76, p 0.013) are predictive for mortality. The receiver‐operating characteristic (ROC) analysis proved EDT [area under the ROC curve (AUC), 0.85; CI: 0.76–0.94; p 0.001], BNP (AUC, 0.83; CI: 0.75–0.91; p 0.001) and age (AUC, 0.82; CI: 0.74–0.90; p 0.001) as indicators for fatalities. In hospitalized patients acutely intoxicated with undifferentiated poisons, EDT as a parameter of left ventricle diastolic function and BNP are useful to early predict mortality.