The role of mid-regional proadrenomedullin in diagnosis of sepsis in intensive care unit patients

Document Type : Original Article

Authors

1 Ministry of Health, Egypt.

2 Department of clinical pathology, Faculty of Medicine, Zagazig University, Egypt.

3 Department of Clinical Pathology, Faculty of Medicine – Zagazig University, Egypt

4 Associate Professor of Anesthesiology and surgical intensive care, Faculty of Medicine, Zagazig University, Egypt

5 Department of clinical pathology, Faculty of Medicine, Zagazig University, Egypt

Abstract

Introduction:
As a major health problem, mortality due to sepsis accounts for about 42% in intensive care deaths. This high mortality rate necessitates rapid and accurate diagnosis of sepsis, differentiating it from other confusing conditions. Rapid and evidence-based management is expected to follow. The use of biomarkers gained high attention in the scientific community for sepsis diagnosis. In the current study, we aim to evaluate the diagnostic accuracy of measuring CRP, PCT and MR-proADM in differentiation between septic and non-septic patients within intensive care unit.
Methods:
A total of 64 subjects were enrolled. They were divided into: (1) control group: 32 Non-septic ICU patients, and (2) case group: 32 septic ICU patients. CBC, CRP, PCT, MR-proADM quantification was done at day 1 of sepsis suspension for case group and randomly for control group.
Results:
At a cut-off 78.479 pg/ml, MR-proADM has 93.8 % sensitivity, 90.6 % specificity, 90.9 % positive predictive value, 93.5% negative predictive value and 92.18 % accuracy.
Conclusion:
Based upon our findings, MR-proADM could be useful as a diagnostic marker in sepsis patients admitted to ICU. It had diagnostic criteria comparable to that of PCT and better than that of CRP.
Key words:
Sepsis, ICU, MR-proADM, CRP, PCT

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Main Subjects