E3 Journal of Medical Research

E3 Journal of Medical Research Vol. 3 (2) pp. 024-029, February 2014; © E3 Journals; ISSN 2276-9900

B-type Natriuretic Peptide (BNP) Cutpoint for Assessing Heart Failure (HF) Patients’ Readmission Within 6 months from an Index Hospitalization

Abstract

The objective of this research was to determine the optimum BNP cutpoint to assess the risk of readmission of HF patients within 6 months from an index HF hospitalization. Heart Failure (HF) is a major cause of morbidity and mortality, with a global prevalence estimated at 16 million people. Understanding its risk factors and predictors will help identify patients at high risk of re-hospitalization and death. We identified 1,255 HF patients with IDC-9 codes 428.X for HF admitted to a Veterans’ hospital between January 2004 and December 2009. Those with at least 2 HF-specific admissions were assessed using C-statistic to determine the optimum BNP cutpoint. Cox proportional hazards and logistic regression analyses were conducted to assess the risk of readmission of the patients. C-statistic value of 0.56 shows an optimum BNP cutpoint at 500 with a p -value of 0.006. Logistic regression and Cox proportional hazards significantly shows that BNP cutpoint value at 500 can predict the risk of readmission of HF patients while adjusting for patients’ age at the first admission. For our population, cut point at 500pg per millimeter is the optimum cutpoint to dichotomize BNP and this cutpoint shows that patients with a BNP value greater than 500 are 1.7 times likely to be readmitted with 6 months post discharge compared to patients with a BNP value less than 500. These results could help clinicians to identify patients at high-risk for re-admission based on their BNP level and provide more intense treatment of their HF.

Keywords: heart failure; BNP; hospital readmissions; cardiovascular disease