title: Performance evaluation of MR-proadrenomedullin and other scoring systems in severe sepsis with pneumonia.
abstract: BACKGROUND
  In sepsis, risk assessment is as crucial as early and accurate diagnosis. In this study, we aimed to evaluate the prognostic value of mid-regional proadrenomedullin (MR-proADM) with other scoring systems in severe sepsis and septic shock patients due to community acquired pneumonia (CAP).
  
  
  METHODS
  Patients were divided into 2 groups as severe sepsis and septic shock due to CAP (group 1, n=31) and only CAP group (group 2, n=26). Serum MR-proADM, procalcitonin (PCT), C-reactive protein (CRP), and d-dimer level were analyzed. Acute Physiological and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, and Pneumonia Severity Index (PSI) were performed for all patients.
  
  
  RESULTS
  There was no difference between groups in terms of serum MR-proADM levels (P=0.780). Serum MR-proADM was not found a significant value for the prediction of death within the 4 and 8 weeks in all patients. SOFA score was the most significant to predict mortality in 4 and 8 weeks (P<0.001). The combination of SOFA score and serum MR-proADM was a strong factor to predict death in 4 weeks (specifity 86.8% and sensitivity 66.7%). The combination of MR-proADM, SOFA score, and APACHE II score was found 75.0% sensitive and 71.4% specific to predict mortality within 4 weeks in group 1.
  
  
  CONCLUSIONS
  The MR-proADM does not correlate with mortality or disease severity to predict mortality. The combination of SOFA, APACHE II scores, and MR-proADM was efficient to predict prognosis and mortality rate in severe sepsis or septic shock patients.
authors.affiliation: 1 Department of Respiratory Care Unit, 2 Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Akpinar
authors.affiliation: 1 Department of Respiratory Care Unit, 2 Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Kazım
authors.initials: K
authors.lastname: Rollas
authors.affiliation: 1 Department of Respiratory Care Unit, 2 Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Alagöz
authors.affiliation: 1 Department of Respiratory Care Unit, 2 Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Seğmen
authors.affiliation: 1 Department of Respiratory Care Unit, 2 Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Education and Research Hospital, Ankara, Turkey.
authors.forename: Tuğrul
authors.initials: T
authors.lastname: Sipit
keywords: Proadrenomedullin (proADM); pneumonia; pneumonia severity index (PSI); scoring systems; sepsis
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