Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia
PRINCIPLES: Midregional proadrenomedullin (proADM) is a novel biomarker with potential prognostic utility in patients with community-acquired pneumonia. The aim of this study was to investigate the value of proADM levels for severity assessment and outcome prediction in severe sepsis and septi...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2012-03-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1440 |
| _version_ | 1797979505185259520 |
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| author | Borja Suberviola Alvaro Castellanos-Ortega Javier Llorca Fernando Ortiz David Iglesias Belen Prieto |
| author_facet | Borja Suberviola Alvaro Castellanos-Ortega Javier Llorca Fernando Ortiz David Iglesias Belen Prieto |
| author_sort | Borja Suberviola |
| collection | DOAJ |
| description |
PRINCIPLES: Midregional proadrenomedullin (proADM) is a novel biomarker with potential prognostic utility in patients with community-acquired pneumonia. The aim of this study was to investigate the value of proADM levels for severity assessment and outcome prediction in severe sepsis and septic shock due to CAP.
METHODS: Prospective observational study including 49 patients admitted to ICU with both a clinical and radiologic diagnosis of pneumonia and fulfilling criteria for severe sepsis or septic shock. The prognostic accuracy of proADM levels was compared with those of pneumonia severity index and of procalcitonin (PCT) and C-reactive protein (CRP).
RESULTS: 49 patients with severe sepsis or septic shock due to CAP were included in the study. Mortality was 24.5% for ICU and 34.7% for hospital mortality. In all cases proADM values at ICU admission were pathological (considering normal proADM levels <4 nmol/L). ProADM consistently rose as PSI class advanced from II to V (p = 0.02). Median proADM levels were higher (p<0.01) in hospital non-survivors 5.0 (1.9–10.1) nmol/L vs. survivors 1.7 (1.3–3.1) nmol/L. These differences were also significant with respect to ICU mortality. The receiver-operating characteristic curve for proADM yielded an AUC of 0.72; better than the AUC for PCT and CRP (0.40 and 0.44 respectively) and similar to PSI (0.74).
CONCLUSIONS: In our study MR-proADM levels correlate with increasing severity of illness and death. High MR-proADM levels offer additional risk stratification in high-risk CAP patients.
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| first_indexed | 2024-04-11T05:40:55Z |
| format | Article |
| id | doaj.art-1d83a62414f54d86baa6061f6b371a83 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T05:40:55Z |
| publishDate | 2012-03-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-1d83a62414f54d86baa6061f6b371a832022-12-22T04:42:32ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972012-03-01142111210.4414/smw.2012.13542Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumoniaBorja SuberviolaAlvaro Castellanos-OrtegaJavier LlorcaFernando OrtizDavid IglesiasBelen Prieto PRINCIPLES: Midregional proadrenomedullin (proADM) is a novel biomarker with potential prognostic utility in patients with community-acquired pneumonia. The aim of this study was to investigate the value of proADM levels for severity assessment and outcome prediction in severe sepsis and septic shock due to CAP. METHODS: Prospective observational study including 49 patients admitted to ICU with both a clinical and radiologic diagnosis of pneumonia and fulfilling criteria for severe sepsis or septic shock. The prognostic accuracy of proADM levels was compared with those of pneumonia severity index and of procalcitonin (PCT) and C-reactive protein (CRP). RESULTS: 49 patients with severe sepsis or septic shock due to CAP were included in the study. Mortality was 24.5% for ICU and 34.7% for hospital mortality. In all cases proADM values at ICU admission were pathological (considering normal proADM levels <4 nmol/L). ProADM consistently rose as PSI class advanced from II to V (p = 0.02). Median proADM levels were higher (p<0.01) in hospital non-survivors 5.0 (1.9–10.1) nmol/L vs. survivors 1.7 (1.3–3.1) nmol/L. These differences were also significant with respect to ICU mortality. The receiver-operating characteristic curve for proADM yielded an AUC of 0.72; better than the AUC for PCT and CRP (0.40 and 0.44 respectively) and similar to PSI (0.74). CONCLUSIONS: In our study MR-proADM levels correlate with increasing severity of illness and death. High MR-proADM levels offer additional risk stratification in high-risk CAP patients. https://www.smw.ch/index.php/smw/article/view/1440CAPpneumoniaproadrenomedullinprocalcitoninSepsis |
| spellingShingle | Borja Suberviola Alvaro Castellanos-Ortega Javier Llorca Fernando Ortiz David Iglesias Belen Prieto Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia Swiss Medical Weekly CAP pneumonia proadrenomedullin procalcitonin Sepsis |
| title | Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia |
| title_full | Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia |
| title_fullStr | Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia |
| title_full_unstemmed | Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia |
| title_short | Prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community-acquired pneumonia |
| title_sort | prognostic value of proadrenomedullin in severe sepsis and septic shock patients with community acquired pneumonia |
| topic | CAP pneumonia proadrenomedullin procalcitonin Sepsis |
| url | https://www.smw.ch/index.php/smw/article/view/1440 |
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