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The Egyptian Journal of Bronchology
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Role of serum proadrenomedullin in assessment of the severity and outcome of hospitalized healthcare-associated pneumonia patients

Egyptian Journal of Bronchology volume 8, pages 108–114 (2014)Cite this article

Abstract

Background

Clinical judgment of healthcare-associated pneumonia (HCAP) represents a major concern as these fragile patients have an unusual presentation that frequently misleads severity assessment and results in poor clinical outcome. The aim of this study was to evaluate the role of proadrenomedullin (proADM) in predicting disease severity and outcome in HCAP patients in comparison with community-acquired pneumonia (CAP) patients.

Patients and methods

Thirty-one HCAP patients and twenty-five CAP patients were enrolled in this study. Measurement of serum proADM level was performed in the first 24-h of admission. Assessment of severity was carried out using the CURB-65 scoring system. Finally, the outcome of the patients was assessed.

Results

Serum proADM level was higher in HCAP patients than that in CAP patients, this difference was statistically significant. Also, serum proADM level increased significantly with increasing severity of HCAP patients guided by CURB-65, with a cut-off value of more than 1.8 nmol/l, with a sensitivity of 91.7%, a specificity of 95%, a positive predictive value of 91.7%, and a negative predictive value of 95%. However, a higher value (>2.9 nmol/l) was detected in HCAP patients who died, with high sensitivity and negative predictive value (100%) and low specificity (42.3%) and positive predictive value (25%).

Conclusion

The use of proADM as a novel biomarker enhances the performance of the CURB-65 scoring system for risk stratification of HCAP patients. Egypt J Broncho 2014 8:108–114

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Authors and Affiliations

  1. Department of Chest, Faculty of Medicine, Zagazig University, Zagazig, 44511, Egypt

    Amany Shaker, Doaa Mostafa Gad & Sameh Embarak

  2. Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Hany A. Labib

Authors
  1. Amany Shaker
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  2. Doaa Mostafa Gad
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  3. Sameh Embarak
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  4. Hany A. Labib
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Correspondence to Sameh Embarak.

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Shaker, A., Gad, D.M., Embarak, S. et al. Role of serum proadrenomedullin in assessment of the severity and outcome of hospitalized healthcare-associated pneumonia patients. Egypt J Bronchol 8, 108–114 (2014). https://doi.org/10.4103/1687-8426.145702

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  • DOI: https://doi.org/10.4103/1687-8426.145702

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