Proadrenomedullin determining clinical severity and analyzing prognostic value for pneumonia.

AIMS: In pneumonia patients, we need practical biomarkers that can contribute to the diagnosis, prognosis and the prediction of mortality, and that can direct therapy and treatment setting. In this study, the diagnostic importance and value to predict prognosis and mortality are investigated for plasma proadrenomedullin (proADM) levels in pneumonia patients. MATERIALS AND METHODS: Sixty-three consecutive patients who had been diagnosed with pneumonia, as well as 54 volunteers as the control group, making 117 in total, enrolled in this study. The participants' ProADM, leukocyte count, erythrocyte sedimentation rate, C-reactive protein, and procalcitonin levels were measured, and their pneumonia severity index (PSI) and CURB-65 scores were calculated. RESULTS: Plasma proADM levels were higher in the controls. When we compare patients' proADM levels in the initiation, and after the treatment, patients' proADM levels were lower on the 7th day after the treatment. No significant supremacy was identified over the other markers. The ProADM levels were significantly correlated with PSI stages, but in deciding of the site of care, the distribution of proADM levels for the PSI and CURB-65 risk groups (as low and high risk) were statistically irrelevant. The mean proADM levels among the patients who developed complications were slightly higher than the others, but not to a statistically significant degree. A relationship was identified between the clinical severity scores and complications, and short-term mortality was 7.93%. The plasma proADM levels among the nonsurvivors were 0.7 nmol/L and 0.90 nmol/L in the survivors. Given these data, proADM failed to predict mortality while PSI and CURB-65 were superior predictors. CONCLUSION: Using proADM levels alone to predict pneumonia prognosis and mortality and deciding upon a therapy setting makes no sense, although in consideration of previous studies, proADM would be useful as a supplementary contributor to clinical severity scores. [ABSTRACT FROM AUTHOR]