Mid-regional pro-adrenomedullin as prognostic biomarker in septic shock

作者：De La Torre Prados Maria Victoria^*; Garcia De La Torre Angela; Enguix Alfredo; Mayor Reyes Maria; Nieto Gonzalez Maria; Garcia Alcantara Angel

来源：Minerva Anestesiologica, 2016, 82(7): 760-766.

• Sepsis
• Biomarkers
• Intensive Care Unit
• Prognosis
• Mortality

BACKGROUND: The aim was to ascertain the prognostic value of mid-regional pro-adrenomedullin (MR-proADM), measured within 24 hours from the onset of septic shock (SS).
METHODS: We performed a prospective, observational study on all patients admitted to our hospital's Intensive Care Unit with SS over a one year period from January to December 2011 to examine the outcomes in 100 consecutive SS cases. Demographic data and severity score (APACHEI and SOFA) were recorded. MR-proADM, C-reactive protein and procalcitonin were measured within the first 24 hours from SS onset. The outcome variable studied was 28-day mortality. Data were evaluated with non-parametric statistics bivariant and multivariate analyses for survival analysis.
RESULTS : In patients who died within 28 days (36%), MR-proADM, Lactate, APACHE II as well as SOFA were significantly higher compared with survivors. MR-proADM showed the best association with 28-day mortality, as well as a prognostic value (logrank test: P= 0.0012). Statistical significance was also seen in the Cox regression analysis (P= 0.0004) for all patients with a Relative Risk of 1.26 times that of the baseline for each mmol/L of increase in MR-proADM.
CONCLUSIONS: In our study MR-proADM levels measured on admission correlates with 28-day mortality in patients with septic shock.

• 出版日期2016-7