Application of receiver operating characteristic curve in the evaluation of predictive value of serum NT-proBNP in weaning outcome of patients with mechanical ventilation
10.3760/cma.j.issn.1671-0282.2010.08.021
- VernacularTitle:ROC曲线评价N端脑钠肽前体对撤机结局的预测价值
- Author:
Bei HU
;
Ming FANG
;
Weiping HUANG
;
Hui LI
;
Wenxin JIANG
;
Hongke ZENG
- Publication Type:Journal Article
- Keywords:
ROC curve;
NT-proBNP;
Intensive care unit;
Spontaneous breathing trial;
Weaning;
Mechanical ventilation;
Cut-off value;
Predictive value
- From:
Chinese Journal of Emergency Medicine
2010;19(8):851-854
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of NT-proBNP in predicting weaning outcomes of the patients with mechanical ventilation by using the receiver operating characteristic (ROC)curve. Method The data of patients after the weaning of mechanical ventilation and spontaneous breathing trial (SBT) in the intensive care unit,from July 2008 to January 2010, were retrospective reviewed. All patients were divided into the success group and failure group as per the outcomes of weaning. Demographics and the serum NT-proBNP levels measured before weaning were compared between two groups with Student t -test and Chi-square test. The ROC curve was drawn to evaluate the value of serum NT-proBNP in predicting outcomes after weaning. Results A total of 160 patients were eligible for inclusion in the study, and there were 106 cases in success group and 54 cases in failure group.Compared with the failure group, the patients of success group were younger (63.17 ± 17.00 vs. 71.28 ± 12.56,t = 2.063,P =0.024), and no difference in gender (χ2 = 0.06, P ＞ 0.05). The NT-proBNP levels of failure group were significantly higher than those of success group (Lg NT-proBNP 2.80 ± 0.72 vs. 3.75 ± 0.56, t =2.351,P =0.014). The area under cure (AUC) of the ROC cure of NT-proBNPto predict the failure of weaning was 0.855 ±0.036 (95%CI0.784 ～ 0.925) when the cut-off level of NT-proBNP was 3635.5 pg/mL. And, this NT-proBNP level had a followed predictive efficiency in weaning outcome (Youden's index: 0. 60, accuracy:82.5%, sensitivity: 75%, specificity: 84.7%, positive likelihood ratio: 4.90, negative likelihood ratio:0.295,Kappa value: 0.62). Conclusions The levels of NT-proBNP before weaning have predictive value in weaning outcome, and it may be used as one of the screening indicators for weaning.
