Proadrenomedullin for prediction of early and mid-term mortality in patients hospitalized for community-acquired pneumonia.

IF 3.7 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY
Amaia Artaraz, Ane Uranga, Ana Jódar, Urko Aguirre, José María Quintana, Carmen Mar, Rosario Menéndez, Javier Aspa, Salvador Bello, Pedro Pablo España, Aitor Ballaz
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引用次数: 0

Abstract

Objectives: Our study sought to determine the usefulness of biomarkers of systemic inflammation (C-reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (proADM)) on hospital admission, as compared to the CURB65 score, for predicting 30- and 90-day mortality in patients hospitalized for community acquired pneumonia (CAP).

Methods: Observational, prospective study of adults admitted for CAP in four Spanish teaching hospitals. Disease severity was determined within the first 24 h of diagnosis, using the CURB65 score. CRP, PCT and proADM levels were assessed from samples obtained in the Emergency Department (ED). We compared the capacity of the different biomarkers and the CURB65 score to predict pneumonia-related 30- and 90-day mortality.

Results: A total of 956 patients hospitalized with CAP were included, 462 in the internal and 494 in the external sample. Of the biomarkers, proADM showed the greatest AUC for predicting 30- and 90-day mortality (0.80 and 0.76 respectively). Mortality at 30 and 90 days increased as proADM levels rose. When proADM was used as a continuous variable, CURB65 showed a similar predictive capacity (AUC 0.80) to both crude and age-adjusted proADM (AUC 0.80 and 0.83 respectively) for 30-day mortality. The same was also true for 90-day mortality. However, proADM used as a categorical variable had a greater predictive capacity for 90-day mortality than the CURB65 score (<0.001).

Conclusions: Amongst patients admitted for CAP, the use of proADM obtained in the ED may be useful for identifying patients at greatest risk of mortality, with a similar predictive capacity to the CURB65 score.

肾上腺髓质素原对社区获得性肺炎住院患者早期和中期死亡率的预测
目的:我们的研究旨在确定住院时全身炎症生物标志物(c反应蛋白(CRP)、降钙素原(PCT)和肾上腺髓素原(proADM))与CURB65评分相比,在预测社区获得性肺炎(CAP)住院患者30天和90天死亡率方面的有用性。方法:对四家西班牙语教学医院收治的成人CAP患者进行观察性、前瞻性研究。使用CURB65评分,在诊断后的前24 h内确定疾病严重程度。从急诊科(ED)获得的样本中评估CRP、PCT和proADM水平。我们比较了不同生物标志物和CURB65评分预测肺炎相关的30天和90天死亡率的能力。结果:共纳入住院CAP患者956例,其中内部样本462例,外部样本494例。在生物标志物中,proADM预测30天和90天死亡率的AUC最高(分别为0.80和0.76)。30和90 d死亡率随proADM水平的升高而升高。当proADM作为一个连续变量时,CURB65对30天死亡率的预测能力(AUC为0.80)与粗proADM和年龄调整proADM (AUC分别为0.80和0.83)相似。90天死亡率也是如此。然而,与CURB65评分相比,proADM作为分类变量对90天死亡率的预测能力更强(结论:在因CAP入院的患者中,使用急诊科获得的proADM可能有助于识别死亡风险最高的患者,其预测能力与CURB65评分相似。
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来源期刊
Clinical chemistry and laboratory medicine
Clinical chemistry and laboratory medicine 医学-医学实验技术
CiteScore
11.30
自引率
16.20%
发文量
306
审稿时长
3 months
期刊介绍: Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!
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