NT-pro-BNP correlates with disease severity and predicts outcome in cerebral haemorrhage patients: Cohort study

Intracerebral haemorrhage (ICH) is a devastating condition, with more than half of patients dying or becoming dependent after such an event. Natriuretic peptides, frequently used in the management of heart failure, have been shown to correlate with disease severity and prognosis in brain disorders. The aim of this study was to test the hypothesis that NT-pro-BNP correlates with disease severity and is an independent prognostic marker for non-traumatic ICH patients.

A consecutive sample of 201 non-traumatic ICH patients, who were non-comatose on admission and medically treated in a stroke unit, were evaluated for in-hospital mortality and three-month functional dependency (modified Rankin Scale >2). NT-pro-BNP measurement was performed after admission. Independent predictors of the outcomes in study were assessed using logistic regression and the incremental value of NT-pro-BNP on three previously validated severity scores was evaluated using the variation in C-statistic (Δc). Values of p < .05 were considered significant.

In-hospital mortality rate was 8.0%, and 40.3% of patients achieved good functional outcome. NT-pro-BNP correlated with hematoma volume (r = 0.186) and amount of intraventricular blood (r = 0.240). Higher levels of NT-pro-BNP were independently associated with death (Expß = 1.650) and functional dependency (Expß = 1.449). NT-pro-BNP increased the discrimination of the ICH-GS for mortality prediction (Δc = 0.043) and of FUNC and ICH scores for functional outcome prediction (Δc = 0.060 and 0.055 respectively). Admission NT-pro-BNP levels were independently associated with hematoma size.

NT-pro-BNP is an independent prognostic factor for low-risk non-traumatic ICH patients and a valid marker of disease severity in this patient population.