Sustained value of proadrenomedullin as mortality predictor in severe sepsis.
J Infect. 2015 Feb 19;
Authors: Andaluz-Ojeda D, Cicuéndez R, Calvo D, Largo E, Nogales L, Muñoz MF, Bueno P, Eiros JM, Gandía F, Bermejo-Martín JF
OBJETIVES: We sought to analyze the role of the novel molecule pro-adrenomedullin (proADM) as predictor of mortality over time in patients with diagnosis of severe sepsis or septic shock and compare it with other biomarkers.
METHODS: Levels of procalcitonin (PCT), C reactive protein (CRP), lactate and proADM in plasma were measured in 71 patients admitted to the ICU with a diagnosis of severe sepsis or septic shock in the first 24 hours following admission to the ICU, and again by day 3 and day 7. We compared the prognostic accuracy of these biomarkers to predict mortality using the area under the receiver operating characteristics curves (AUROC) and employed Kaplan Meier curves for evaluating survival mean time depending on ProADM levels.
RESULTS: ProADM showed the best diagnosis accuracy for predicting mortality in all the time points analyzed as evidenced an AUROC of 0.75, 0.83 and 0.84 at day 1, 3 and 7 respectively. ProADM level = 0.94 nmol/L was identified as a perfect cut-off value for predicting survival. Furthermore Spearman-Karber test evidenced a significant association between proADM and SOFA score in all the time points evaluated.
CONCLUSIONS: proADM is an excellent marker of mortality risk and disease severity along time in severe sepsis and septic shock providing a selective advantage over other biomarkers as prognostic tool in this severe condition.
PMID: 25704281 [PubMed - as supplied by publisher]