RT Journal Article
T1 Usefulness of midregional proadrenomedullin to predict poor outcome in patients with community acquired pneumonia
A1 Gordo Remartínez, Susana
A1 Calderón Moreno, María
A1 Fernández Herranz, Juan
A1 Castuera Gil, Ana
A1 Gallego Alonso-Colmenares, María Del Mar
A1 Puertas López, Carolina
A1 Nuevo González, José Antonio
A1 Sánchez Sendín, Domingo
A1 García Gámiz, Mercedes
A1 Sevillano Fernández, José Antonio
A1 Álvarez Sala, Luis A.
A1 Andueza Lillo, Juan Antonio
A1 Salas Álvarez, Jesús De La Ascensión
A1 Miguel Yanes, José María De
AB Backgroundmidregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP). We sought to confirm whether MR-proADM added to Pneumonia Severity Index (PSI) improves the potential prognostic value of PSI alone, and tested to what extent this combination could be useful in predicting poor outcome of patients with CAP in an Emergency Department (ED).MethodsConsecutive patients diagnosed with CAP were enrolled in this prospective, single-centre, observational study. We analyzed the ability of MR-proADM added to PSI to predict poor outcome using receiver operating characteristic (ROC) curves, logistic regression and risk reclassification and comparing it with the ability of PSI alone. The primary outcome was “poor outcome”, defined as the incidence of an adverse event (ICU admission, hospital readmission, or mortality at 30 days after CAP diagnosis).Results226 patients were included; 33 patients (14.6%) reached primary outcome. To predict primary outcome the highest area under curve (AUC) was found for PSI (0.74 [0.64-0.85]), which was not significantly higher than for MR-proADM (AUC 0.72 [0.63-0.81, p > 0.05]). The combination of PSI and MR-proADM failed to improve the predictive potential of PSI alone (AUC 0.75 [0.65-0.85, p=0.56]). Ten patients were appropriately reclassified when the combined PSI and MR-proADM model was used as compared with the model of PSI alone. Net reclassification improvement (NRI) index was statistically significant (7.69%, p = 0.03) with an improvement percentage of 3.03% (p = 0.32) for adverse event, and 4.66% (P = 0.02) for no adverse event.ConclusionMR-proADM in combination with PSI may be helpful in individual risk stratification for short-term poor outcome of CAP patients, allowing a better reclassification of patients compared with PSI alone.
PB Public Library of Science
YR 2015
FD 2015-06-01
LK https://hdl.handle.net/20.500.14352/92664
UL https://hdl.handle.net/20.500.14352/92664
LA eng
NO Gordo-Remartínez S, Calderón-Moreno M, Fernández-Herranz J, Castuera-Gil A, Gallego Alonso-Colmenares M, Puertas-López C, Nuevo-González JA, Sánchez-Sendín D, García-Gámiz M, Sevillano-Fernández JA, Álvarez-Sala LA, Andueza-Lillo JA, de Miguel-Yanes JM. Usefulness of midregional proadrenomedullin to predict poor outcome in patients with community acquired pneumonia. PLoS One. 2015 Jun 1;10(6):e0125212
DS Docta Complutense
RD 11 abr 2025