• Eur. J. Clin. Invest. · Jun 2020

    Observational Study

    MR- proADM to detect specific types of organ failure in infection.

    • Cristina Andrés, David Andaluz-Ojeda, Ramón Cicuendez, Leonor Nogales, Silvia Martín, Marta Martin-Fernandez, Raquel Almansa, Dolores Calvo, Maria Carmen Esteban-Velasco, Luis Mario Vaquero-Roncero, Alberto Ríos-Llorente, Elisa Sanchez-Barrado, Luis Muñoz-Bellvís, César Aldecoa, and Jesus F Bermejo-Martin.
    • Clinical Analysis Service, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
    • Eur. J. Clin. Invest. 2020 Jun 1; 50 (6): e13246.

    BackgroundFollowing the SEPSIS-3 consensus, detection of organ failure as assessed by the SOFA (Sequential Organ Failure Assessment) score, is mandatory to detect sepsis. Calculating SOFA outside of the Intensive Care Unit (ICU) is challenging. The alternative in this scenario, the quick SOFA, is very specific but less sensible. Biomarkers could help to detect the presence of organ failure secondary to infection either in ICU and non-ICU settings.Materials And MethodsWe evaluated the ability of four biomarkers (C-Reactive protein (CRP), lactate, mid-regional proadrenomedullin (MR-proADM) and procalcitonin (PCT)) to detect each kind of organ failure considered in the SOFA in 213 patients with infection, sepsis or septic shock, by using multivariate regression analysis and calculation of the area under the receiver operating curve (AUROC).ResultsIn the multivariate analysis, MR-proADM was an independent predictor of five different failures (respiratory, coagulation, cardiovascular, neurological and renal). In turn, lactate predicted three (coagulation, cardiovascular and neurological) and PCT two (cardiovascular and renal). CRP did not predict any of the individual components of SOFA. The highest AUROCs were those of MR-proADM and PCT to detect cardiovascular (AUROC, CI95%): MR-proADM (0.82 [0.76-0.88]), PCT (0.81 [0.75-0.87] (P < .05) and renal failure: MR-proADM (0.87 [0.82-0.92]), PCT (0.81 [0.75-0.86]), (P < .05). None of the biomarkers tested was able to detect hepatic failure.ConclusionsIn patients with infection, MR-proADM was the biomarker detecting the largest number of SOFA score components, with the exception of hepatic failure.© 2020 Stichting European Society for Clinical Investigation Journal Foundation.

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