ArticleJournal of general internal medicine2026
Extremely High NT-proBNP in Unselected Hospital Admissions: A Retrospective Analysis of Diagnoses and Outcomes.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundElevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations are commonly interpreted as suggestive of heart failure (HF) but may also occur in the context of acute systemic illness and infection.
objectivesTo evaluate diagnoses and outcomes among hospitalised adults with extremely high NT-proBNP.
designRetrospective cohort study.
participantsAdult hospital admissions with NT-proBNP concentrations ≥ 20,000 pg/mL. MAIN MEASURES: Clinical and laboratory data as well as primary diagnosis and all-cause mortality were recorded. Survivors and non-survivors at 6 months were compared. Overall survival was assessed using Kaplan-Meier analysis; associations with mortality were evaluated using multivariable Cox regression. KEY
resultsA total of 415 admissions were included. Median age was 82 years (IQR 73-88), 51.6% were male and median NT-proBNP was 35,000 pg/mL (IQR 26,563-35,000). The most common imaging findings were pulmonary congestion (55.4%) and infection (53.7%). Infection was the most common primary diagnosis (60%) and cause of death (71%), while HF was the primary diagnosis in 19%. Mortality was high: 43.6% in hospital and 64.5% at 6 months. Patients with infection had significantly higher mortality than those with other diagnoses. Cox regression showed older age and lower serum albumin were independent predictors of mortality.
conclusionIn unselected hospitalised patients, extremely high NT-proBNP levels were more frequently associated with infection and high mortality than with HF. NT-proBNP values occurred across a heterogenous range of acute illnesses and should be interpreted within the wider clinical context rather than as evidence of a single disease process.
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