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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2016 Luglio;82(7):760-6
Mid-regional pro-adrenomedullin as prognostic biomarker in septic shock
Maria V. DE LA TORRE-PRADOS 1, Angela GARCIA-DE LA TORRE 2, Alfredo ENGUIX 2, Maria MAYOR-REYES 3, María NIETO-GONZÁLEZ 1, Angel GARCIA-ALCANTARA 1 ✉
1 Department of Intensive Care Medicine, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Malaga University, Malaga, Spain; 2 Clinical Chemistry Department, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Malaga University, Malaga, Spain; 3 Clinical Chemistry Department, Hospital Universitario Virgen de la Victoria, Malaga, Spain
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 (APACHEII 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.