The prognostic value of NT-proBNP in 28-day mortality and post-discharge survival in pneumonia: a retrospective cohort study from Taiwan

Background: NT-proBNP, traditionally used to assess heart failure, is increasingly recognized for its prognostic value in other diseases. This study evaluates its value in pneumonia. Research design and methods: We conducted a retrospective cohort study of adult patients hospitalized for pneumonia at Wan Fang Hospital (2017–2021) to investigate whether elevated NT-proBNP levels predicted poorer outcomes. Logistic regression identified risk factors for 28-day mortality, while the Cox regression model identified predictors of post-discharge survival. Results: Among 2,805 patients (79.6 ± 13.4 years, female 45%), the 28-day mortality rate was 18.2%, and the median post-discharge follow-up time was 359 days. Moderately (increased but < 10000 pg/mL) and severely (>10000 pg/mL) elevated NT-proBNP levels had higher 28-day mortality compared to normal NT-proBNP; adjusted odds ratios: 2.24 (1.34–3.75, p = 0.002) and 3.57 (2.03–6.27, p < 0.001). Moderately and severely elevated NT-proBNP levels related to shorter survival time than normal NT-proBNP levels; adjusted hazard ratios 1.60 (1.28–2.00, p < 0.001) and 2.03 (1.56–2.63, p < 0.001). All ratios were adjusted with comorbidities, sex, age, and clinical and laboratory tests. Conclusions: Elevated NT-proBNP levels predict higher 28-day mortality and shorter survival time in patients with pneumonia across most subpopulations. This marker holds potential as a prognostic biomarker for pneumonia, especially in high-risk patients.