Abstract
BACKGROUND: Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, and the burden of the disease is increasing on a daily basis. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is an established biomarker for diagnosis and prognosis in HF, but its relationship with length of hospital stay remains underexplored. Understanding this association may help in early risk stratification and optimize healthcare resource utilization. OBJECTIVE: To evaluate the correlation between NT-proBNP levels and length of hospital stay in patients admitted with HF and to identify clinical predictors of in-hospital mortality. METHODS: This retrospective observational study included 45 patients admitted with HF to Father Muller Medical College Hospital, Mangalore, between October 2024 and May 2025. Demographic, clinical, echocardiographic, and laboratory data, including NT-proBNP levels, were collected from hospital records. Statistical analyses were performed using Jamovi 2.7 and R Studio. Correlations were assessed using Spearman's rank test, and predictors of in-hospital mortality were evaluated with univariate Firth logistic regression and ROC analysis. RESULTS: The mean age of participants was 64.8 ± 10.5 years; 53.3% were female. The mean NT-proBNP level was 6443 ± 4953 pg/mL, and the mean hospital stay was 10.8 ± 6.4 days. NT-proBNP levels were significantly higher in non-survivors (10977 ± 5687 pg/mL) than survivors (5607 ± 4396 pg/mL; p = 0.027). A moderate positive correlation was observed between NT-proBNP and hospital stay (ρ = 0.425, p = 0.004). ROC analysis identified an NT-proBNP cut-off of 8823 pg/mL for predicting mortality (AUC = 0.76, sensitivity = 86%, specificity = 79%). CONCLUSION: Elevated NT-proBNP levels at admission are strongly associated with prolonged hospital stay and increased in-hospital mortality among HF patients. NT-proBNP may serve as a valuable biomarker for early risk stratification and assessing prognosis, enabling efficient resource allocation.