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Elevated BMI and NT-proBNP: a potential safety predictor for community acquired pneumonia discharge from the emergency department

European Journal of Clinical Nutrition volume 76, pages 1044–1045 (2022)Cite this article

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While Lee maximizes 30-mortality prediction at an NT-proBNP threshold of 1.319.8 pg/mL with a focus on inpatient mortality [1], we pursue optimization of our model’s sensitivity and negative predictive value to safely discern those overweight and obese patients diagnosed with CAP that may be safely discharged from the Emergency Department. Specifically, NT-proBNP levels above 679 ng/L yield a substantial negative predictive value (98.7%; 95% IC: 91.8–99.8) and sensitivity (91.7%; 95% IC: 61.599.8) and thus enable 30-day mortality prediction in CAP.

Of note, none of those high-BMI CAP survivors required telemetry monitoring or intensive care, and could have been treated as outpatients. Given that the average direct cost of CAP inpatient care in our National Health Service is $10,963 ($10,823–$11,102), in retrospect our model would have safely prevented 25,6% (n = 39) of admissions which would amount to $427,538 savings in a 1 year period.

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References

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Authors and Affiliations

  1. Emergency department, Laredo Hospital, Laredo. IDIVAL, Laredo, Cantabria, Spain

    Manuel Antonio Tazón-Varela

  2. Community Health Group Marqués de Valdecilla University Hospital and Health Research Institute (IDIVAL), Santander, Spain

    Manuel Antonio Tazón-Varela, Héctor Alonso-Valle & Pedro Muñoz-Cacho

  3. Emergency department, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain

    Héctor Alonso-Valle

  4. FNCS. Neurocritical Care Division Chief. Department of Neurology & Rehabilitation, Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA

    Ciro Ramos-Estebanez

  5. Radiology department, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain

    Jaime Gallo-Terán

  6. Primary care Unit, Cantabria Health Institution. IDIVAL, Santander, Cantabria, Spain

    Pedro Muñoz-Cacho

Authors
  1. Manuel Antonio Tazón-Varela
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  2. Héctor Alonso-Valle
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  3. Ciro Ramos-Estebanez
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  4. Jaime Gallo-Terán
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  5. Pedro Muñoz-Cacho
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Contributions

MATV: Conceived and designed the experiments, Performed the experiments, Analyzed the data, Contributed reagents/materials/analysis tools, Wrote the paper. PMC: Conceived and designed the experiments, Performed the experiments, Analyzed the data, Contributed reagents/materials/analysis tools, Wrote the paper. CR-E: Conceived and designed the experiments, Performed the experiments, Analyzed the data, Contributed reagents/materials/analysis tools, Wrote the paper. JGT: Conceived and designed the experiments, Performed the experiments, Analyzed the data, Contributed reagents/materials/analysis tools, Wrote the paper. HAV: Conceived and designed the experiments, Performed the experiments, Analyzed the data, Contributed reagents/materials/analysis tools, Wrote the paper.

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Correspondence to Héctor Alonso-Valle.

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Tazón-Varela, M.A., Alonso-Valle, H., Ramos-Estebanez, C. et al. Elevated BMI and NT-proBNP: a potential safety predictor for community acquired pneumonia discharge from the emergency department. Eur J Clin Nutr 76, 1044–1045 (2022). https://doi.org/10.1038/s41430-021-01066-2

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  • DOI: https://doi.org/10.1038/s41430-021-01066-2

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