How biomarkers can improve pneumonia diagnosis and prognosis: procalcitonin and mid-regional-pro-adrenomedullin

Biomark Med. 2020 May;14(7):549-562. doi: 10.2217/bmm-2019-0414. Epub 2020 May 28.

Abstract

Aim: The diagnostic and prognostic role of procalcitonin (PCT) and mid-regional-pro-adrenomedullin (MR-proADM) were investigated in patients with pneumonia. Material & methods: A total of 168 and 77 patients with pneumonia enrolled in two different hospital settings, an internal medicine unit and an emergency unit were included in the study. PCT and MR-proADM plasma concentrations and pneumonia severity index score were measured. Median values were compared by Mann-Whitney's test. Receiver operating characteristic analysis and rank correlation were used to define the diagnostic and prognostic accuracy. Results: PCT confirmed the diagnostic role at values 0.08-0.10 ng/ml and MR-proADM the prognostic role for severe pneumonia. Significant correlation (p < 0.0001) between MR-proADM and pneumonia severity index score indicated expression of pneumonia severity. Conclusion: This combination of biomarkers presents a high positive predictive value in pneumonia diagnosis and prognosis.

Keywords: MR-proADM; PCT; comorbidity; disease severity; emergency department; internal medicine department; pneumonia; risk stratification.

MeSH terms

  • Adrenomedullin / blood*
  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonia / blood*
  • Pneumonia / diagnosis*
  • Procalcitonin / blood*
  • Prognosis
  • ROC Curve

Substances

  • Biomarkers
  • Procalcitonin
  • Adrenomedullin