Reliability of Pro-adrenomedullin and Interleukin 1ß in Predicting Severity of Community-Acquired Pneumonia in Pediatric Patients.

ABSTRACT

OBJECTIVES: Community-acquired pneumonia (CAP) in children is one of the most important causes of mortality and morbidity in developing countries. Therefore, it is very important for clinicians to detect the presence and severity of pneumonia. Proadrenomedullin (Pro-ADM) and Interleukin-1ß (IL-1ß) are thought to have potential for CAP evaluation in children. We sought to investigate the value of Pro-ADM and IL-1ß levels for severity assessment and outcome prediction in children with CAP. METHODS: A total of 66 hospitalized CAP patients were included in a prospective observational study. Complete blood count, serum C-reactive protein (CRP), Pro-ADM and IL-1ß levels were studied in blood samples obtained from the patients upon admission. Respiratory Clinical Score (RCS) was performed to determine the respiratory distress and severity. RESULTS: The comparison of data with laboratory-severity groups serum CRP, Pro-ADM and IL-1ß levels increased in parallel with the disease severity. Pro-ADM was the best biomarker for severity stratification. Logistic regression analysis revealed that RCS >6 points and Pro-ADM values >1.75 nmol/L combination had the most significant results (OR 15.38, 95% CI 1.35-166.66, p=0.027). Moreover, a relationship was found between the high serum levels of IL-1ß and requirement of intervention procedures in patients with pleural effusion. CONCLUSIONS: Serum Pro-ADM and IL-1ß levels may offer additional risk/severity stratification in children with CAP. In addition, they may be helpful in predicting the development of complications, requirements for ntensive care unit admission, and intervention procedures.