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Thirty and ninety days mortality predictive value of admission and in-hospital procalcitonin and mid-regional pro-adrenomedullin testing in patients with dyspnea. Results from the VERyfing DYspnea trial
- Source :
- The American journal of emergency medicine. 32(4)
- Publication Year :
- 2013
-
Abstract
- Mid-regional pro-atrial natriuretic peptide (MR-proANP), procalcitonin (PCT), and mid-regional pro-adrenomedullin (MR-proADM) demonstrated usefulness for management of emergency department patients with dyspnea.To evaluate in patients with dyspnea, the prognostic value for 30 and 90 days mortality and readmission of PCT, MR-proADM, and MR-proANP, a multicenter prospective study was performed evaluating biomarkers at admission, 24 and 72 hours after admission. Based on final diagnosis, patients were divided into acute heart failure (AHF), primary lung diseases, or both (AHF + NO AHF).Five hundred one patients were enrolled. Procalcitonin and MR-proADM values at admission and at 72 hours were significantly (P.001) predictive for 30-day mortality: baseline PCT with an area under the curve (AUC) of 0.70 and PCT at 72 hours with an AUC of 0.61; baseline MR-proADM with an AUC of 0.62 and MR-proADM at 72 hours with an AUC of 0.68. As for 90-day mortality, both PCT and MR-proADM baseline and 72 hours values showed a significant (P.0001) predictive ability: baseline PCT with an AUC of 0.73 and 72 hours PCT with an AUC of 0.64; baseline MR-proADM with an AUC of 0.66 and 72 hours MR-proADM with an AUC of 0.71. In AHF, group biomarkers predicted rehospitalization and mortality at 90 days, whereas in AHF + NO AHF group, they predict mortality at 30 and 90 days.In patients admitted for dyspnea, assessment of PCT plus MR-proADM improves risk stratification and management. Combined use of biomarkers is able to predict in the total cohort both rehospitalization and death at 30 and 90 days.
- Subjects :
- Calcitonin
Lung Diseases
Male
medicine.medical_specialty
medicine.drug_class
Calcitonin Gene-Related Peptide
Risk Assessment
Procalcitonin
Hospital
mr-proanp
pct
mr-proadm
dyspnea
Adrenomedullin
Patient Admission
Predictive Value of Tests
Internal medicine
80 and over
Natriuretic peptide
medicine
Humans
In patient
Hospital Mortality
Prospective Studies
Protein Precursors
Intensive care medicine
Prospective cohort study
Aged
Aged, 80 and over
Heart Failure
Emergency Service
Lung
business.industry
General Medicine
Emergency department
medicine.disease
Prognosis
Biomarkers
Dyspnea
Emergency Service, Hospital
Female
Italy
medicine.anatomical_structure
Heart failure
Cohort
Emergency Medicine
business
hormones, hormone substitutes, and hormone antagonists
Subjects
Details
- ISSN :
- 15328171
- Volume :
- 32
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The American journal of emergency medicine
- Accession number :
- edsair.doi.dedup.....c127fe3543a31ae7201785f520126e2b