Prognostic value of serum proadrenomedullin in catheter-related bloodstream infection in the intensive care unit: A prospective observational study.
Medicine (Baltimore)
; 97(42): e12821, 2018 Oct.
Article
in En
| MEDLINE
| ID: mdl-30334979
ABSTRACT
Patients with catheter-related bloodstream infection (CRBSI) have a poor prognosis. Proadrenomedullin (pro-ADM) has emerged as a valuable marker of sepsis. The potential role of pro-ADM in predicting the prognosis of CRBSI was evaluated. We enrolled 25 CRBSI patients and pro-ADM level was measured within 24âhours after each admission. Survival was assessed after 28 days. Among 25 patients with CRBSI, 14 patients survived. Pro-ADM in survivors was significantly lower than that in non-survivors (3.71â±â1.30 vs 5.58â±â1.18ânmol/L). The area under the curve (AUC) for pro-ADM was 0.87 (95% CI 0.68-0.97) with a cut-off value of 4.67ânmol/L, providing sensitivity of 85.7% and specificity of 81.8%. The AUCs for PCT, WBC, and CRP were 0.76 (95% CI 0.55-0.90), 0.72 (95% CI 0.50-0.88), and 0.69 (95% CI 0.48-0.86), respectively. Kaplan-Meier survival curves showed pro-ADM ≥ 4.67ânmol/L was associated with higher mortality (log-rank pâ=â0.001). Moreover, the pro-ADM level was significantly higher in patients with septic shock than those without shock (5.44â±â1.17 vs 3.54â±â1.18nmol/L). The mortality of patients with septic shock was higher than that of patients without shock (69.2% vs 16.7%, Pâ=â.008). In conclusion, pro-ADM could be used as a prognostic marker of CRBSI in critically ill patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Protein Precursors
/
Shock, Septic
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Biomarkers
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Adrenomedullin
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Catheter-Related Infections
Type of study:
Diagnostic_studies
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Etiology_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Medicine (Baltimore)
Year:
2018
Document type:
Article