Atrial ejection force and brain natriuretic peptide as markers for mortality in sepsis

Background: In early stages of septic shock, impaired myocardial function plays an important prognostic role. AEF and Plasma BNP level may be a valuable prognostic factor for patients with sepsis. Objective: We aimed also to evaluate the value of atrial ejection force (AEF) B-type natriuretic peptide (BNP) in predicting the outcome of sepsis, severe sepsis and septic shock patients. Methods: 40 patients presenting with sepsis, severe sepsis or septic were included in the study. The patients had undergone transthoracic Echocardiographic examinations and BNP measurements on the 1st and 3rd day of admission. The patients were retrospectively divided into survivors and non survivors. Results: There was a significant statistical difference in BNP level (P = 0.0001) between the two groups. BNP showed a statistically significant rise in the non survival group from day 1 to day 3 (p = 0.002) and a statistically significant decrease from day 1 to day 3 in the survived group (p = 0.001). As regards the echo findings there was a statistically significant difference AEF 3rd day between survivors and non survivors (P = 0.0001). The ROC curve showed that BNP 1st day, 3rd day are good tests for prediction of mortality in patients with sepsis. Conclusion: Atrial ejection force on the first day of admission, unlike BNP level, might not be used as an independent predictor of mortality in patients with sepsis. BNP level correlates with the severity of sepsis. According to our study, AEF in the third day may be a good predictor for survival of patients presenting with sepsis