title: Midregional proadrenomedullin for prognosis in community-acquired pneumonia: a systematic review.
abstract: The initial prognostic assessment of patients with community-acquired pneumonia( CAP) has important clinical implications. We hypothesized that midregional proadrenomedullin(MR-proADM) is a valuable test for the prediction of outcomes in patients with CAP.Methods: We performed a systemic review of the literature and a meta-analysis to evaluate the prognostic value of MR-proADM for short and long-term mortality in patients with CAP.Results: Twelve studies were included in the systematic review. Elevated MR-proADM was associated with an increase in short-term mortality (OR Z 6.8; 95% CI: 4.65-10.13; P value < 0.001) and complications (OR = 5.0; 95% CI: 3.86-6.49; P value < 0.001). The pooled analysis of 4 studies showed an improvement in the discriminant ability by 8% (95% CI: 2%e14%)when MR-proADM was added to CURB-65/CRB-65. Studies that reported long-term prognosis indicated an increased risk of death in patients with elevated MR-proADM.Conclusion: Elevated level of MR-proADM is significantly associated with both short-term mortality and complications in patients with CAP. Studies also indicate that MR-proADM has prognostic value for prediction of long-term mortality in these patients. The addition of MR-proADM improves the discriminant ability of CURB-65/CRB-65.
authors.affiliation: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, KY, USA. r0cava01@louisville.edu
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cavallazzi
authors.forename: Karim
authors.initials: K
authors.lastname: El-Kersh
authors.forename: Emran
authors.initials: E
authors.lastname: Abu-Atherah
authors.forename: Sonal
authors.initials: S
authors.lastname: Singh
authors.forename: Yoon K
authors.initials: YK
authors.lastname: Loke
authors.forename: Timothy
authors.initials: T
authors.lastname: Wiemken
authors.forename: Julio
authors.initials: J
authors.lastname: Ramirez
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D015982:Bias; D015415:Biomarkers / Q000097:blood; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C088633:proadrenomedullin; D053607:Adrenomedullin