Abstract 2919: Medical And Economic Long-term Effects Of B-type Natriuretic Peptide Testing In Patients With Acute Dyspnea
Background: The objective of this prospective study was to assess the medical and economic long-term effects of using B-type natriuretic peptide (BNP) levels in the management of patients with acute dyspnea.
Methods: We performed follow-up analysis of BASEL, a randomized study including 452 patients who presented to the emergency department with acute dyspnea. Participants were randomly assigned to a diagnostic strategy involving the rapid measurement of BNP levels (n=225) or assessment in a standard manner (n=227). Mortality was assessed at 720 days, morbidity and economic data at 360 days.
Results: BNP testing induced several important changes in initial patient management including a reduction in the initial hospital admission rate, the use of intensive care, as well as initial time to discharge. At 720 days, 172 deaths had occurred. Cumulative all-cause 720-day mortality was not different between the BNP group (37%) and the control group (36%, P =0.6). Morbidity as reflected by days spent in-hospital at 360 days was significantly lower in the BNP group (median 12 days [IQR 2–28]) as compared to the control group (median 16 days [IQR 7–32], P =0.025). Functional status was similar in both groups. Economic outcome as quantified by total treatment cost at 360 days was significantly improved in the BNP group (mean $10,144 versus $12,748 in the control group, P =0.008).
Conclusions: Rapid BNP testing in patients with acute dyspnea has no effect on long-term mortality. However, morbidity as quantified by days spent in-hospital and economic outcome are still improved at 360 days.