A study of mid-regional-proadrenomedullin in community-acquired pneumonia and sepsis as a prognostic marker

Background Mid-regional (MR)-proadrenomedullin has shown to be a sole diagnostic biomarker in sepsis and septic shock due to pneumonia in recent studies. Aim Evaluation of the usefulness of MR-proadrenomedullin either alone or combined with pneumonia severity index (PSI) and Confusion, Urea, Respiratory rate, Blood pressure (CURB-65) in prognosticating the outcomes of community-acquired pneumonia (CAP) with or without sepsis or septic shock. Patients and methods A total of 80 participants were included and sectioned into groups: group I included 30 participants diagnosed as CAP; group II included 30 participants diagnosed as CAP and sepsis; group III included 20 apparently healthy normal volunteers. MR-proadrenomedullin was measured in the serum of patients and volunteers by enzyme linked immunosorbent assay (ELIZA). Results PSI, CURB-65, and MR-proadrenomedullin showed a statistically significant increase in group II as opposite to group I. There were a significant positive correlation between MR-Pro-AMD and both PSI and CURB-65. Percentage of survival and death rate in patients’ groups in 30 days follow-up showed a statistically significant increase of death rate in group II. Conclusion Septic shock is related to higher death rate more than patients with sepsis and severe sepsis. PSI and CURB- 65 score together are excellent tools in predicting the outcome of CAP patients. MR-proadrenomdullin has high sensitivity and specificity for detecting sepsis with CAP.