REVIEW   Free access

Minerva Anestesiologica 2021 October;87(10):1117-27

DOI: 10.23736/S0375-9393.21.15585-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

The diagnostic accuracy of mid-regional pro-adrenomedullin for sepsis: a systematic review and meta-analysis

Peijuan LI, Chunmei WANG ✉, Shuqin PANG

Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China

INTRODUCTION: The incidence and mortality of sepsis are high, and common biomarkers are not perfect. To identify a biomarker with high specificity and sensitivity for sepsis, we evaluated the current literature on the performance of mid-regional pro-adrenomedullin (MR-proADM) in the diagnosis of sepsis.
EVIDENCE ACQUISITION: According to appropriate eligibility and exclusion criteria, PubMed, EMBASE, Cochrane Library, China Journal full-text Database, Wanfang Database and Chinese Journal Full Text Database were searched for “mid-regional pro-adrenomedullin,” “MR-proADM,” “sepsis,” “pyemia,” “pyohemia,” “septicemia,” and “blood poisoning.” The publication dates considered for the search were from inception until August 31^st, 2020. The risk of bias was assessed according to QUADAS-2 criteria.
EVIDENCE SYNTHESIS: Eleven studies involving 2038 cases were included. MR-proADM had high sensitivity and specificity in the diagnosis of sepsis, with values of 0.83 (95% CI: 0.79-0.87) and 0.90 (95% CI: 0.83-0.94), respectively. The odds ratio of a combined diagnosis was 41.35, and the area under the curve (AUC) was 0.91. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L. MR-proADM may also have value in distinguishing pathogens and identifying sepsis severity and organ failure.
CONCLUSIONS: MR-proADM is an excellent biomarker for the diagnosis of sepsis with high sensitivity and specificity. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L.

KEY WORDS: Sensitivity and specificity; Human mid-regional pro-adrenomedullin; Sepsis