Introduction
Measurement of biomarkers is a potential approach to early assessment and prediction of mortality in septic patients. The purpose of this study was to ascertain the prognostic value of pro-adrenomedullin (pADM), measured in all patients admitted to the ICU of our hospital with a diagnosis of severe sepsis or septic shock during 1 year.
Methods
A cohort study of 117 patients >18 years with severe sepsis according to the Surviving Sepsis Campaign, in an ICU of a university hospital. Demographic, clinical parameters and pADM, C-reactive protein and procalcitonin were studied during 1year. Descriptive and comparative statistical analysis was performed using the statistical software packages Statistica Stat Soft Inc 7.1 and MedCalc 9.2.1.0.
Results
We analyzed 117 consecutive episodes of severe sepsis (15%) or septic shock (85%) in the ICU. The median age of the patients was 64 (interquartile range, 53 to 72) years; the main sources of infection were respiratory tract (46%) and intra-abdomen (21%). The 28-day mortality was 32.5%. The profile of death patients had a significantly higher average age (64.7 vs. 57.6 years; P = 0.024), as well as clinical severity scores, APACHE II (26.6 vs. 23; P = 0.006) and SOFA (11.6 vs. 89.2; P < 0.001). Kaplan-Meier survival analysis was significant. P = 0.0017 for patients with pADM <1.2 nmol/l. Cox regression analysis also showed statistical significance (P = 0.0033) and a likelihood ratio = 1.18 per each 1 nmol/l increase in pADM.
Conclusion
The protein pADM is an important prognostic biomarker of survival when measured on admission of septic patients to the ICU.
References
Pezzilli R, Barassi A, Pigna A, et al.: Time course of proadrenomedullin in the early phase of septic shock. A comparative study with other proinflammatory proteins. Panminerva Med 2012, 54: 211-217.
Wang RL, Kang FX: Prediction about severity and outcome of sepsis by proatrial natriuretic peptide and pro-adrenomedullin. Chin J Traumatol 2010, 13: 152-157.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
De La Torre-Prados, M., Garcia-De la Torre, A., Enguix, A. et al. Pro-adrenomedullin as prognostic biomarker in the sepsis. Crit Care 17 (Suppl 2), P33 (2013). https://doi.org/10.1186/cc11971
Published:
DOI: https://doi.org/10.1186/cc11971