brain natriuretic peptide levels and days of hospitalization in elderly patients admitted for acute heart failure

background Acute heart failure(AHF)is a frequent condition associated to high mortality and morbility among elderly patients admitted to In-ternal ad Emergency Medicine departments. Length of hospitalization is associated to higher mortality among medical patients. Increased brain natriuretic peptide(BNP) levels have been associated,in AHF patients,to increased mortality and morbidity. Our aim is to evaluate if BNP levels can be associated to longer hospitalizations in this subset.Methods We enrolled 400 consecutive patients admitted to our Internal Medicine Department with a clinical diagnosis of AHF. BNP was evaluatedin all the patients,who were stratified in four categories: patients with BNP less than 100pg/ml (group 1),101-500pg/ml (group 2),501-1500pg/ml (group 3) and BNP higher than 1501pg/ml (group 4). Each patient un-derwent to a complete diagnostic workup. Patients with BNP levels less than 100 pg/ml or a final diagnosis other than AHF were excluded. Ka-plan-Meier model with log-rank test was used to assess the differences.results 293 patients were suitable for final analysis.Mean age was 80±9.85 years,males represented 58% of the sample. Among patients who were successfully dismissed,group 4 had a significantly longer ho-spitalization (16.6 days,95%CI:13.7-19.5)than patients in group 3(13.1 days,95%CI:11.7-14.6) and group 2(12.3 days,95%CI: 10.6-13.9)(p<0.05,all ties).conclusion BNP is useful for diagnosis and prognostic stratification in patients with AHF.If confirmed in larger cohorts,it could also predict longer hospitalizations in this specific subset of patients.