Superior accuracy of mid-regional proadrenomedullin for mortality prediction in sepsis with varying levels of illness severity

Background The use of novel sepsis biomarkers has increased in recent years. However, their prognostic value with respect to illness severity has not been explored. In this work, we examined the ability of mid-regional proadrenomedullin (MR-proADM) in predicting mortality in sepsis patients with dif...

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Published in:Annals of intensive care 2017-12, Vol.7 (1), p.15-15, Article 15
Main Authors: Andaluz-Ojeda, David, Nguyen, H. Bryant, Meunier-Beillard, Nicolas, Cicuéndez, Ramón, Quenot, Jean-Pierre, Calvo, Dolores, Dargent, Auguste, Zarca, Esther, Andrés, Cristina, Nogales, Leonor, Eiros, Jose María, Tamayo, Eduardo, Gandía, Francisco, Bermejo-Martín, Jesús F., Charles, Pierre Emmanuel
Format: Article
Language:English
Subjects:
Accuracy
Anesthesiology
Biomarkers
Critical Care Medicine
Emergency Medicine
Human health and pathology
Intensive
Intensive care
Life Sciences
Medicine
Medicine & Public Health
Mortality
Multivariate analysis
Sepsis
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Summary:Background The use of novel sepsis biomarkers has increased in recent years. However, their prognostic value with respect to illness severity has not been explored. In this work, we examined the ability of mid-regional proadrenomedullin (MR-proADM) in predicting mortality in sepsis patients with different degrees of organ failure, compared to that of procalcitonin, C-reactive protein and lactate. Methods This was a two-centre prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to the ICU. Plasma biomarkers were measured during the first 12 h of admission. The association between biomarkers and 28-day mortality was assessed by Cox regression analysis and Kaplan–Meier curves. Patients were divided into three groups as evaluated by the Sequential Organ Failure Assessment (SOFA) score. The accuracy of the biomarkers for mortality was determined by area under the receiver operating characteristic curve (AUROC) analysis. Results A total of 326 patients with severe sepsis (21.7%) or septic shock (79.3%) were enrolled with a 28-day mortality rate of 31.0%. Only MR-proADM and lactate were associated with mortality in the multivariate analysis: hazard ratio 8.5 versus 3.4 ( p  
ISSN:2110-5820
2110-5820
DOI:10.1186/s13613-017-0238-9