Assessment of proadrenomedullin as diagnostic or prognostic biomarker of acute appendicitis in children with acute abdominal pain

• Published in: The American journal of emergency medicine 2019-07, Vol.37 (7), p.1289-1294
• Main Authors: Oikonomopoulou, Niki, Míguez-Navarro, Concepción, Rivas-García, Arístides, García Gamiz, Mercedes, López-López, Rosario, Oliver-Sáez, Paloma, Riaño-Méndez, Bibiana, Farfan-Orte, Tamara, Lobato-Salinas, Zulema, Rúbies-Olives, Júlia, Llena-Isla, Priscila, Lancho-Monreal, Encarnación María
• Format: Article
• Language: English
• Subjects: Abdomen; Abdomen, Acute - blood; Abdominal pain; Adrenomedullin; Adrenomedullin - blood; Appendicitis; Appendicitis - blood; Biomarkers; Biomarkers - blood; Blood Cell Count; C-reactive protein; C-Reactive Protein - analysis; Child; Children; Clinical medicine; Emergency medical care; Epidemiology; Etiology; Female; Guardians; Hospitals; Humans; Laboratories; Leukocytes (neutrophilic); Male; Medical diagnosis; Medical prognosis; Mortality; Neutrophils; Pain; Patients; Pediatrics; Pneumonia; Proadrenomedullin; Prognosis; Prospective Studies; Protein Precursors - blood; Sensitivity and Specificity; Surgeons; Surgery
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2018.09.038

Acute appendicitis (AA) is one of the most frequent surgical pathologies in pediatrics. To investigate the utility of proadrenomedullin (pro-ADM) for the diagnosis of AA. Prospective, analytical, observational, and multicenter study conducted in 6 pediatric emergency departments. Children up to 18 years of age with suspected AA were included. Clinical, epidemiological, and analytical data were collected. We studied 285 children with an average age of 9.5 years (95% confidence interval [CI], 9.1–9.9). AA was diagnosed in 103 children (36.1%), with complications in 10 of them (9.7%). The mean concentration of pro-ADM (nmol/L) was higher in children with AA (0.51 nmol/L, SD 0.16) than in children with acute abdominal pain (AAP) of another etiology (0.44 nmol/L, SD 0.14; p