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MR‐ proADM to detect specific types of organ failure in infection
Author(s) -
Andrés Cristina,
AndaluzOjeda David,
Cicuendez Ramón,
Nogales Leonor,
Martín Silvia,
MartinFernandez Marta,
Almansa Raquel,
Calvo Dolores,
EstebanVelasco Maria Carmen,
VaqueroRoncero Luis Mario,
RíosLlorente Alberto,
SanchezBarrado Elisa,
MuñozBellvís Luis,
Aldecoa César,
BermejoMartin Jesus F.
Publication year - 2020
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13246
Subject(s) - procalcitonin , medicine , sepsis , receiver operating characteristic , intensive care unit , sofa score , biomarker , septic shock , disseminated intravascular coagulation , respiratory failure , organ dysfunction , area under the curve , gastroenterology , cardiology , intensive care medicine , biochemistry , chemistry
Background Following the SEPSIS‐3 consensus, detection of organ failure as assessed by the SOFA (Sequential Organ Failure Assessment) score, is mandatory to detect sepsis. Calculating SOFA outside of the Intensive Care Unit (ICU) is challenging. The alternative in this scenario, the quick SOFA, is very specific but less sensible. Biomarkers could help to detect the presence of organ failure secondary to infection either in ICU and non‐ICU settings. Materials and methods We evaluated the ability of four biomarkers (C‐Reactive protein (CRP), lactate, mid‐regional proadrenomedullin (MR‐proADM) and procalcitonin (PCT)) to detect each kind of organ failure considered in the SOFA in 213 patients with infection, sepsis or septic shock, by using multivariate regression analysis and calculation of the area under the receiver operating curve (AUROC). Results In the multivariate analysis, MR‐proADM was an independent predictor of five different failures (respiratory, coagulation, cardiovascular, neurological and renal). In turn, lactate predicted three (coagulation, cardiovascular and neurological) and PCT two (cardiovascular and renal). CRP did not predict any of the individual components of SOFA. The highest AUROCs were those of MR‐proADM and PCT to detect cardiovascular (AUROC, CI95%): MR‐proADM (0.82 [0.76‐0.88]), PCT (0.81 [0.75‐0.87] ( P < .05) and renal failure: MR‐proADM (0.87 [0.82‐0.92]), PCT (0.81 [0.75‐0.86]), ( P < .05). None of the biomarkers tested was able to detect hepatic failure. Conclusions In patients with infection, MR‐proADM was the biomarker detecting the largest number of SOFA score components, with the exception of hepatic failure.