Mahmoud Farhoud, MD 1,2, Paul Ndunda, MD 2,K James Kallail, PhD 2, Hussam Farhoud, MD, FACC 3 1 University of Central Florida College of Medicine, 2 University of Kansas School of Medicine, 3 Heartland Cardiology, Wichita, Kansas Impact of Serial B-Type Natriuretic Peptide Measurements on Clinical Outcomes of Acute Heart Failure Methods: Results: Introduction: Conclusion: Limitations: Acute decompensated heart failure is the leading cause of hospitalization in the US. There is a strong need to avoid readmission and decrease length of stay. B-type natriuretic peptide (BNP) levels are helpful in the diagnosis of acute heart failure; however it is unclear if serial BNP measurements are helpful in clinical management. We determined whether the use of serial BNP measurements is associated with improved outcomes, decreased 30 day readmission rate, and shorter hospital length of stay (LOS) in patients with acute heart failure. A retrospective cohort study was conducted in two community hospitals in the United States (751 beds and 300 beds respectively). A total of 555 patients, who were admitted with heart failure during a 1-year period, were identified by diagnosis-related group (DRG) and classified into 2 groups: Group 1 patients had BNP checked no more than once, and Group 2 patients had BNP checked more than once (Table1). Charts were reviewed for length of stay, discharge status, in-hospital mortality rate, and readmission rate. This is a retrospective study There was no assessment of the severity of heart failure Other reasons may explain the association between the number of BNP measurements and the length of stay. Repeated BNP measurements were not associated with in-hospital mortality, length of stay, or 30 day readmission rate. Our data is consistent with the study by Singer et al (2009)., which showed no benefit from serial BNP testing. However, our findings were not consistent with the results of Green et al (2007)., which showed improved outcomes with serial proBNP measurements. Patients with at least one BNP ordered had a lower average LOS than those with more than one BNP measurement. Generally, the more BNPs ordered, the longer the length of stay (average LOS 4.34 days vs.6.11 days, P<0.0001) (Figure 1). There were no differences in the average admission BNP value between the two groups (1181 pg/ml vs pg/ml, P=0.11). There was considerable variation in the average number of BNP measurements by admitting service (Figure 2). There was no correlation between the average number of BNP measurements and the 30-day readmission status (readmission vs. no readmission, 2.56 vs. 2.56). There was also no correlation between the number of BNP measurements and the in-hospital mortality rate (died vs. survived, 2.54 vs. 2.56) (Figure3). Table 1 Figure 1 Figure 2 Figure 3 TotalGroup 1 (n=176)Group 2 (n=379) Age, mean (SD)71.86 (14.23) Male (%) African American (%) White (%) Hispanic (%)434 Mean BNP (SD)1132 (1087)1181 (1079)1472 (1087) Median BNP