Exploratory analysis of BNP, NLR and APACHE II in assessing the mortality risk of elderly patients with severe pneumonia

Background and aimsSevere pneumonia represents a serious threat to the health of elderly individuals. This study aims to exploratory analyse the effect of B-type natriuretic peptide (BNP), the neutrophil to lymphocyte ratio (NLR), and APACHE II scores for assessing the 28-day mortality risk in elderly patients with severe pneumonia.MethodsOur study enrolled 80 elderly patients with severe pneumonia (53 males and 27 females). The associations of NLR, oxygenation index (PaO2/FiO2), and acute physiology and chronic health score II (APACHE II) with 28-day mortality risk were assessed using multivariable logistic regression hazards model. The predictive value of BNP, NLR, and APACHE II scores for 28-day mortality risk in this patient population was assessed by receiver operating characteristic (ROC) curves.ResultsBNP (odds ratio [OR], 1.007; 95% confidence interval [CI], 1.002-1.012; <i>P</i> < 0.05), NLR (OR, 1.496; 95% CI, 1.002-2.192; <i>P</i> < 0.05), and APACHE II scores (OR, 1.411; 95% CI, 1.102-1.806; <i>P</i> < 0.05) were independent risk factors for 28-day mortality in elderly patients with severe pneumonia. ROC curve analysis demonstrated that the combination of BNP, NLR, and APACHE II scores exhibited a strong predictive value for 28-day mortality risk in elderly patients with severe pneumonia, with an area under the ROC curve (AUC) of 0.966 and a specificity of 87.10%.Discussion and conclusionThis single-center retrospective analysis showed that elevated BNP levels (≥286.5 pg/mL), elevated NLR levels (≥15.76), and increased APACHE II score (≥25.5 points) were associated with an increased 28-day mortality risk in elderly patients with severe pneumonia.