ArticleBMC infectious diseases2012
Utility of Procalcitonin (PCT) and Mid regional pro-Adrenomedullin (MR-proADM) in risk stratification of critically ill febrile patients in Emergency Department (ED). A comparison with APACHE II score.
Article in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Accuracy of procalcitonin for diagnosing sepsis in adult patients admitted to the emergency department: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
- Predicting mortality in adult patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review.BMC emergency medicine · 2021Pooled it
- Mid-Regional Proadrenomedullin in Cerebrospinal Fluid Is a Reliable Diagnostic and Prognostic Marker for Acute Meningoencephalitis and Neurological Disorders.Journal of clinical laboratory analysis · 2025Article
- Observational
- Biomarkers and Fever in Children with Cancer: Kinetics and Levels According to Final Diagnosis.Children (Basel, Switzerland) · 2021Article
- Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department.Medicina (Kaunas, Lithuania) · 2021Review
- Observational
- Pro-atrial natriuretic peptide and pro-adrenomedullin before cardiac surgery in children. Can we predict the future?PloS one · 2020Article
- Midregional Proadrenomedullin (MRproADM) Serum Levels in Critically Ill Patients Are Associated with Short-Term and Overall Mortality during a Two-Year Follow-Up.Mediators of inflammation · 2020Article
- The early identification of disease progression in patients with suspected infection presenting to the emergency department: a multi-centre derivation and validation study.Critical care (London, England) · 2019Observational
- Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study.PloS one · 2019Observational
- Mid-Regional Pro-Adrenomedullin (MR-proADM) as a Biomarker for Sepsis and Septic Shock: Narrative Review.Healthcare (Basel, Switzerland) · 2018Review
- Superior accuracy of mid-regional proadrenomedullin for mortality prediction in sepsis with varying levels of illness severity.Annals of intensive care · 2017Article
- Article
- Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy.Intensive care medicine · 2016Review
- Prognostic value of procalcitonin in hospitalized patients with lower respiratory tract infections.Revista Brasileira de terapia intensiva · 2016Review
- Procalcitonin, MR-Proadrenomedullin, and Cytokines Measurement in Sepsis Diagnosis: Advantages from Test Combination.Disease markers · 2015Article
- Performance evaluation of MR-proadrenomedullin and other scoring systems in severe sepsis with pneumonia.Journal of thoracic disease · 2014Article
- Plasma adrenomedullin is associated with short-term mortality and vasopressor requirement in patients admitted with sepsis.Critical care (London, England) · 2014Article
- Sustained elevation of resistin, NGAL and IL-8 are associated with severe sepsis/septic shock in the emergency department.PloS one · 2014Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of our study was to evaluate the prognostic value of MR-proADM and PCT levels in febrile patients in the ED in comparison with a disease severity index score, the APACHE II score. We also evaluated the ability of MR-proADM and PCT to predict hospitalization.
methodsThis was an observational, multicentric study. We enrolled 128 patients referred to the ED with high fever and a suspicion of severe infection such as sepsis, lower respiratory tract infections, urinary tract infections, gastrointestinal infections, soft tissue infections, central nervous system infections, or osteomyelitis. The APACHE II score was calculated for each patient.
resultsMR-proADM median values in controls were 0.5 nmol/l as compared with 0.85 nmol/l in patients (P < 0.0001), while PCT values in controls were 0.06 ng/ml versus 0.56 ng/ml in patients (P < 0.0001). In all patients there was a statistically significant stepwise increase in MR-proADM levels in accordance with PCT values (P < 0.0001). MR-proADM and PCT levels were significantly increased in accordance with the Apache II quartiles (P < 0.0001 and P = 0.0012 respectively).In the respiratory infections, urinary infections, and sepsis-septic shock groups we found a correlation between the Apache II and MR-proADM respectively and MR-proADM and PCT respectively. We evaluated the ability of MR-proADM and PCT to predict hospitalization in patients admitted to our emergency departments complaining of fever. MR-proADM alone had an AUC of 0.694, while PCT alone had an AUC of 0.763. The combined use of PCT and MR-proADM instead showed an AUC of 0.79.
conclusionsThe present study highlights the way in which MR-proADM and PCT may be helpful to the febrile patient's care in the ED. Our data support the prognostic role of MR-proADM and PCT in that setting, as demonstrated by the correlation with the APACHE II score. The combined use of the two biomarkers can predict a subsequent hospitalization of febrile patients. The rational use of these two molecules could lead to several advantages, such as faster diagnosis, more accurate risk stratification, and optimization of the treatment, with consequent benefit to the patient and considerably reduced costs.
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