ProBNP versus MEDS Score in Determining the Prognosis of Sepsis Patients; a Diagnostic Accuracy Study

Introduction: Probrain natriuretic peptide (ProBNP) can act as an independent predictor of mortality in septic patients. This study aimed to compare the diagnostic accuracy of proBNP and Mortality in Emergency Department Sepsis (MEDS) score in this regard.Method: This crosssectional study was conducted on gt; 14 years old sepsis patients of an emergency department (ED), during 2 years. The level of ProBNP and MEDS score were measured for all eligible patients and considering onemonth mortality as reference, screening performance characteristics of the two tests were compared using SPSS 21 and STATS 11.Results: 121 patients with the mean age of 75.87±11.82 years were studied (55.4% male). 85 (70.25%) patients had moderate to high probability of mortality according to MEDS score. The mean ProBNP levels of survivor and nonsurvivor patients were 489.69 ± 327.47 and 3954.98 ± 2717.85 pg/ml, respectively (p lt; 0.0001). Sensitivity and specificity of ProBNP (in 1000 pg/ml cut off) and MEDS score (in level 3) in prediction of 1month mortality were 93.6 (83.797.9), 94.8 (84.798.6), 65.0 (51.976.3), and 98.2 (89.599.9), respectively. Area under the ROC curve of the two tests were 97.36 (95% CI: 92.9294.48) and 92.31 (95% CI: 86.3596.53), respectively (p = 0.0543).Conclusion: ProBNP and MEDS score both have excellent diagnostic accuracy in predicting 1month mortality of sepsis patients. However, considering the higher sensitivity as well as availability and ease of calculation, it seems that ProBNP can be considered an appropriate tool for screening patients with high risk of mortality following sepsis in ED.