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Usefulness of midregional pro- adrenomedullin as a marker of organ damage and predictor of mortality in patients with sepsis
dc.contributor.author | Vera, María del Carmen | |
dc.contributor.author | Medina, Blanca | |
dc.contributor.author | Martínez, Mónica | |
dc.contributor.author | Callejo, Victoria | |
dc.contributor.author | Valero, Salvador | |
dc.contributor.author | Marín, Irene | |
dc.contributor.author | Muñoz, Ángeles | |
dc.contributor.author | Bernal Morell, Enrique | |
dc.contributor.author | García Villalba, Eva | |
dc.contributor.author | Alcaráz García, Antonia | |
dc.contributor.author | Cinesi Gómez, César | |
dc.contributor.author | Cano Sánchez, Alfredo | |
dc.contributor.author | Piñera Salmerón, Pascual | |
dc.date.accessioned | 2024-02-12T08:10:24Z | |
dc.date.available | 2024-02-12T08:10:24Z | |
dc.date.issued | 2018 | |
dc.identifier.citation | Bernal-Morell E, García-Villalba E, Vera MDC, Medina B, Martinez M, Callejo V, et al. Usefulness of midregional pro-adrenomedullin as a marker of organ damage and predictor of mortality in patients with sepsis. J Infect. 2018;76:249-57. | es |
dc.identifier.uri | http://hdl.handle.net/10952/7333 | |
dc.description.abstract | Background: Midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP) and sepsis. In this paper, we examined the ability of MR-proADM to predict organ damage and long-term mortality in sepsis patients, compared to that of procalcitonin, C-reactive protein and lactate. Methods: This was a prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to internal service department. The association between biomarkers and 90-day mortality was assessed by Cox regression analysis and Kaplan–Meier curves. The accuracy of biomarkers for mortality was determined by area under the receiver operating characteristic curve (AUROC) analysis. Results: A total of 148 patients with severe sepsis, according to the criteria of the campaign to survive sepsis, were enrolled. Eighty-five (57.4%) had sepsis according to the new criteria of Sepsis-3. MR-proADM showed the best AUROC to predict sepsis as defined by the Sepsis-3 criteria (AUROC of 0.771, 95% CI 0.692–0.850, p <0.001) and was the only marker independently asso- ciated with Sepsis-3 criteria (OR = 4.78, 95% CI 2.25–10.14; p < 0.001) in multivariate analysis.MR-proADM was the biomarker with the best AUROC to predict mortality in 90 days (AUROC of 0.731, CI 95% 0.612–0.850, p <0.001) and was the only marker that kept its indepen- dence [hazard ratio (HR) of 1.4, 95% CI 1.2-1.64, p <0.001] in multivariate analysis. The cut-off point of MR-proADM of 1.8 nmol/L (HR of 4.65, 95% CI 6.79–10.1, p < 0.001) was the one that had greater discriminative capacity to predict 90 days mortality. All patients with MR-proADM concentrations ≤0.60 nmol/L survived up to 90 days. In patients with SOFA ≤ 6, the addition of MR-proADM to SOFA score increased the ability of SOFA to identify non-survivors, AUROC of 0.65 (CI 95% 0.537–0.764) and AUROC of 0.700 (CI 95% 0.594–0.800), respectively (p < 0.05 for both). Conclusions: MR-proADM is a good biomarker in the early identification of high risk septic patients and may contribute to improve the predictive capacity of SOFA scale, especially when scores are low. | es |
dc.language.iso | es | es |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.title | Usefulness of midregional pro- adrenomedullin as a marker of organ damage and predictor of mortality in patients with sepsis | es |
dc.type | article | es |
dc.rights.accessRights | openAccess | es |
dc.journal.title | Journal of Infection | es |
dc.volume.number | 76 | es |
dc.description.discipline | Medicina | es |
dc.identifier.doi | https://doi.org/10.1016/j.jinf.2017.12.003 | es |