血浆脑钠肽水平评估老年心源性脑卒中预后的价值

目的探讨血浆脑钠肽(BNP)水平对老年心源性脑卒中的预后判断价值。方法心源性脑卒中患者80例,按照BNP水平是否超过200 ng/L分为两组,每组40例。对所有患者随访1年,统计其发生大动脉粥样硬化、再发脑栓塞及小动脉闭塞等并发症的比例以及两组高血压、冠心病、糖尿病、高脂血症、慢阻肺发生率,比较两组脑梗死面积及1年生存率。结果 BNP≥200 ng/L组发生大动脉粥样硬化、再发脑栓塞及小动脉闭塞等并发症的比例显著高于BNP200 ng/L组(P0.05),并发高血压、冠心病、糖尿病、高脂血症、慢阻肺等疾病的比例均高于BNP200 ng/L组(P0.05),脑梗死面积显著大于BNP200 ng/L组(P0.05),1年生存率低于BNP200 ng/L组(P0.05)。结论监测血清BNP能有效预测心源性脑卒中患者脑损伤程度,指导脑损伤治疗,预测脑卒中患者预后。     

肥胖心衰患者N端脑钠肽前体的预后价值评价

心衰（HF）时血中N端脑钠肽前体（NTproBNP）水平将升高,而血中NTproBNP水平又与体重指数（BMI）逆相关。然而迄今关于在慢性HF患者,血中NTproBNP与BMI间关系以及两者在判别慢性HF患者远期预后中的意义均未清楚,本文就此进行了分析。     

脑钠肽对心血管病患者近期心源性死亡的预测价值

目的脑钠肽(BNP)主要由心室分泌的一种多肽类激素,其对国人心血管病患者近期预后评估的价值尚未确定,本研究旨在探讨脑钠肽对国人心血管病患者近期发生心源性死亡的预测价值.方法使用BIOSITE Triage脑钠肽干氏快速检测方法对107例住院心血管病患者入院1～3 d的脑钠肽水平进行测量,随访1月,分为存活组和死亡组.结果①存活组和死亡组脑钠肽水平差异有极显著统计学意义(U=148,P＜0.000 5);②血脑钠肽浓度与心率、左室舒张末期内径、心力衰竭史和心肌梗死史呈正相关(r=0.28,P=0.000 4;r=0.49,P＜0.000 5;r=0.39,P＜0.000 5;r=0.21,P=0.03),与左室射血分数呈负相关(r=-0.63,P＜0.000 5);③脑钠肽预测1月内心源性死亡的ROC曲线下面积为0.89,95%可信区间为0.79～0.98,P＜0.000 5;Logistic逐步回归分析表明,惟有血脑钠肽浓度大于755pg/mL是近期心源性死亡的独立预测因子(OR=17.6,95%可信区间为8.7～66.5,P＜0.000 5).结论脑钠肽对心血管病患者1月内心源性死亡的发生有极高的预测价值.     

血清脑钠肽前体联合乳酸清除率评估无创通气治疗心源性肺水肿近期预后的价值

目的：探讨血清脑钠肽前体（pro-BNP）联合乳酸清除率（LCR）在无创通气治疗心源性肺水肿近期预后评估中的价值。方法：收集急性心源性肺水肿患者70例,所有患者均行无创通气治疗,以无创通气治疗7d或改为有创通气为研究终点,观察患者的近期预后。根据患者的生存状况分为生存组（52例）和死亡组（18例）,根据患者是否改为有创机械通气分为无创通气组（61例）和有创通气组（9例）。检测患者治疗前、治疗6h后血清pro-BNP、动脉血乳酸及碱剩余水平,并记录患者急性生理与慢性健康状况评估（APACHE Ⅱ）评分。结果：各组患者治疗前血清pro-BNP、动脉血乳酸、初始碱剩余（BE）水平、APACHE Ⅱ评分及治疗6h后碱剩余差值（6h△BE）比较,差异无统计学意义（均P＞0.05）。治疗6h后,死亡组患者血清pro-BNP水平及APACHE Ⅱ评分显著高于生存组,血LCR显著低于生存组（均P<0.05）。治疗6h后,有创通气组患者血清pro-BNP水平及APACHE Ⅱ评分显著高于无创通气组,血LCR显著低于无创通气组（均P<0.05）。血LCR＞40%的患者中生存组占84.62%,≤40%患者中生存组占15.38%,差异有统计学意义（P＜0.05）;血LCR＞40%的患者改为有创通气占22.22%,≤40%患者中改为有创通气占77.78%,差异有统计学意义（P＜0.05）。血LCR与无创通气治疗的疗效呈正相关（r=0.506,P=0.025）,血清pro-BNP水平与无创通气治疗的疗效呈负相关（r=-0.306,P=0.017）。结论：治疗6h后LCR、血清pro-BNP水平可用于评估无创通气治疗心源性肺水肿7d内预后,有助于判断是否需要改为有创机械通气。     

N端脑钠肽前体与心力衰竭的研究进展

脑钠肽和N端脑钠肽前体是心脏分泌的肽类激素。心力衰竭时,心室壁压力升高增加其分泌量。最近的研究发现N端脑钠肽前体是心力衰竭的诊断、预后、危险分层和个体化治疗有用的指标。本文综述近年来N端脑钠肽前体在心力衰竭中的研究进展。     

N末端脑钠肽前体对非心源性危重患者预后判断的应用

目的评价血浆N末端脑钠肽前体（N—terminal pro-brain natriurelic peptide,NT．proBNP）对非心源性危重患者预后评估的价值。方法选择2009年12月至2010年11月在常德市第一人民医院重症监护病房（intensive care unit,ICU）住院的128例非心源性疾病成年患者为研究对象,在其入ICU的24h内检测血浆NT—proBNP浓度,计算其急性生理学及慢性健康状况评分（acute physiology and chronic health evaluation。APACHEII）,记录随访患者人ICU后28d内的生存状况,并根据以上数据绘制受试者工作特征（ROC）曲线,分析血浆NT．proBNP浓度与28d病死率的关系。结果128例患者中,88例存活,40例死亡。死亡组血浆NT-proBNP浓度J6656（310～35000）ng／L眠1213（17～33061）ng／L,P〈0．05]及APACHEⅡ评分[21（13～53）分US．18（5—38）分,P〈0．05]高于存活组,差异有统计学意义。血浆NT、proBNP浓度预测患者入ICU后28d内死亡的曲线下面积比APACHEⅡ评分高,差异有统计学意义（0．804±0．039vs.0．673±0．048,P〈0．05）;血浆NT．proBNP浓度〉1984ng／L时预测患者28d内死亡的敏感性为87．5％．特异性为62．5％。结论血浆NT、proBNP浓度对非心源性危重患者的预后具有较好的预测价值,超过1984ng／L者预后不良。     

N末端脑钠肽前体对脓毒症患者预后的早期预测价值

目的:探讨N末端脑钠肽前体(NT-proBNP)作为脓毒症患者预后早期预测指标的可行性。方法:分析我院急诊重症监护室2008年1月至2012年12月收治的100例脓毒症患者病历资料,记录其年龄,性别,既往史,入院6 h内NT-proBNP、肌钙蛋白(cTn)I、动脉血乳酸值、C反应蛋白(CRP)、降钙素原(PCT),预后及发病至死亡时间。根据COX回归分析结果,绘制受试者工作特征曲线(ROC曲线),分析入院6 h内NT-proBNP与脓毒症预后的相关性。结果:COX回归分析显示,年龄[相对危险度(RR)=1.027,95%可信区间(CI):1.002～1.052,P=0.033]、入院6 h内NT-proBNP(RR=1.606,95%CI:1.190～2.267,P=0.002)、乳酸(RR=1.718,95%CI:1.250～2.361,P=0.001)是患者28 d死亡的相关因素。ROC曲线显示,年龄[曲线下面积(AUC)=0.656,P<0.001),与发病至死亡时间不存在线性相关。结论:NT-proBNP的高低与脓毒症患者预后相关,但与发病至死亡的时间不存在线性关系。早期NT-proBNP升高对于提示脓毒症患者的危重程度有一定帮助。     

机械通气对老年肺动脉高压伴呼吸衰竭患者血浆脑钠肽水平的影响

目的 探讨机械通气对肺动脉高压伴呼吸衰竭患者血浆脑钠肽(BNP)水平的影响.方法 选择肺动脉高压伴呼吸衰竭患者60例,随机分成两组,每组30例,有创机械通气组在常规治疗的基础上给予气管切开或气管插管呼吸机辅助呼吸,无创机械通气组在常规治疗的基础上给予面罩呼吸机辅助呼吸,分别观察治疗前及治疗24 h后两组患者血气分析、血浆BNP含量及肺动脉压的变化.结果 治疗24 h后两组患者动脉血气分析指标均较治疗前有明显改善(P＜0.05),并且有创机械通气组较无创机械通气组改善明显(P＜0.05);治疗24 h后无创机械通气组和有创机械通气组患者血浆BNP含量及肺动脉压力明显降低(P＜0.05),无创机械通气组患者较有创机械通气组患者下降明显(P＜0.05).结论 机械通气治疗肺动脉高压伴呼吸衰竭患者效果显著,明显改善血气分析指标,降低BNP水平及肺动脉压力,并且有创机械通气效果优于无创机械通气.     

脑钠肽和氨基端脑钠肽前体的临床应用进展

脑钠肽和氨基端脑钠肽前体是近期发现的与心血管疾病密切相关的少数几种有力的血清标志物之一,其血浆水平的升高与左室功能下降程度密切相关,且在心衰的排除诊断方面具有极高的诊断价值,而进一步的研究发现这两者与其它心血管疾病如心肌缺血和高血压等的病变程度及预后同样有着良好的相关性,具有一定的临床应用前景。     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

目的 探讨B型利钠肽(BNP)浓度是否预测急诊非心源性危重患者的28 d病死率.方法 测量255例急诊室非心源性危重患者血中BNP浓度,并记录各项化验指标和临床生理指标.随访28 d患者是否存活,进一步分析人选时血BNP水平与28 d病死率的关系.结果 28 d共有71例死亡,死亡组患者的血BNP浓度中位数水平明显高于存活组(326.0 ng/L比50.9 ng/L,P<0.001),BNP水平预测28 d病死率的ROC曲线下面积为0.825,血BNP预测患者病死率的最佳界值点是114.0 ns/L,血BNP>114.0 ng/L(RR 7.268,95%CI 3.864～13.672)和急性生理学及慢性健康状况评分(APACHE)Ⅱ评分>20(RR 3.330,95%CI 1.815～6.109)是预测患者28 d病死率的独立危险因素.结论 血BNP水平是预测急诊非心源性危苇患者28 d病死率的独立指标,应用BNP预测危重患者病死率的能力优于急诊室常用的快速急性生理学评分与快速急诊医学评分系统,与经典的APACHE Ⅱ评分十分相近.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.     

B型利钠肽对非心源性危重患者的预后价值

Objective B-type natriuretic peptide(BNP) have been used widely in the diagnosis and prognosis of cardiogenic diseases, but the association between BNP concentrations and non-cardiogenic critical illness is unknown. Our study aims at investigating the role of natriuretic peptide testing for predicting 28-day mortality of non-cardiogenic critically ill patients in emergency department (ED). Methods A total of 255 non-cardiogenic critically ill patients treated in the emergency department were prospectively enrolled and a sample of blood was obtained for BNP measurement from each patient. A variety of clinical and laboratory variables were recorded. After 28 days, the vital status of each patient was ascertained and the association between BNP values at presentation and mortality was assessed. Results 71 patients died during the 28-day observation period. Median BNP concentrations at presentation among decedents were significantly higher than those of survivors (326. 0 ng/L versus 50. 9 ng/L,P <0. 001). The optimal BNP cut point for predicting 28-day mortality was 114. 0 ng/L. In a multivariate analysis (Cox-regression), a BNP concentration greater than 114. 0 ng/L(RR 7. 268, 95% CI 3. 864-13. 672) and an Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores greater than 20 (RR 3. 330, 95% CI 1. 815-6. 109)were the independent predictors of the 28-day mortality. BNP concentration alone had an area under the receiver operating characteristic curve (AUC) of 0. 825 for predicting mortality. Conclusions BNP concentrations at presentation are strong predictor of 28-day mortality in patients with non-cardiogenic critically ill patients in ED, which is better than Rapid Acute Physiology Score (RAPS) , Rapid Emergency Medicine Score (REMS) and APACHE Ⅱ score.