title: Mid-regional pro-adrenomedullin as prognostic biomarker in septic shock.
abstract: The aim was to ascertain the prognostic value of mid-regional pro-adrenomedullin (MR-proADM), measured within 24 hours from the onset of septic shock (SS).
  
  
  
  We performed a prospective, observational study on all patients admitted to our hospital's Intensive Care Unit with SS over a one year period from January to December 2011 to examine the outcomes in 100 consecutive SS cases. Demographic data and severity score (APACHEII and SOFA) were recorded. MR-proADM, C-reactive protein and procalcitonin were measured within the first 24 hours from SS onset. The outcome variable studied was 28-day mortality. Data were evaluated with non-parametric statistics bivariant and multivariate analyses for survival analysis.
  
  
  
  In patients who died within 28 days (36%), MR-proADM, Lactate, APACHE II as well as SOFA were significantly higher compared with survivors. MR-proADM showed the best association with 28-day mortality, as well as a prognostic value (logrank test: P=0.0012). Statistical significance was also seen in the Cox regression analysis (P=0.0004) for all patients with a Relative Risk of 1.26 times that of the baseline for each mmol/L of increase in MR-proADM.
  
  
  
  In our study MR-proADM levels measured on admission correlates with 28-day mortality in patients with septic shock.
authors.affiliation: Department of Intensive Care Medicine, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Malaga University, Malaga, Spain - mariav.torre.sspa@juntadeandalucia.es.
authors.forename: Maria V
authors.initials: MV
authors.lastname: DE LA Torre-Prados
authors.forename: Angela
authors.initials: A
authors.lastname: Garcia-DE LA Torre
authors.forename: Alfredo
authors.initials: A
authors.lastname: Enguix
authors.forename: Maria
authors.initials: M
authors.lastname: Mayor-Reyes
authors.forename: María
authors.initials: M
authors.lastname: Nieto-González
authors.forename: Angel
authors.initials: A
authors.lastname: Garcia-Alcantara
mesh_terms: D018806:APACHE; D053607:Adrenomedullin / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000032:analysis; D006801:Humans; D063305:Organ Dysfunction Scores; D011379:Prognosis; D011446:Prospective Studies; D012772:Shock, Septic / Q000401:mortality*; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D015415:Biomarkers; D053607:Adrenomedullin; D002116:Calcitonin; D002097:C-Reactive Protein