Abstract
SummaryIntroduction The initial prognostic assessment of patients with community-acquired pneumonia (CAP) has important clinical implications. We hypothesized that midregional proadrenomedullin (MR-proADM) is a valuable test for the prediction of outcomes in patients with CAP. Methods We performed a systemic review of the literature and a meta-analysis to evaluate the prognostic value of MR-proADM for short and long-term mortality in patients with CAP. Results Twelve studies were included in the systematic review. Elevated MR-proADM was associated with an increase in short-term mortality (OR = 6.8; 95% CI: 4.65-10.13; P value < 0.001) and complications (OR = 5.0; 95% CI: 3.86-6.49; P value < 0.001). The pooled analysis of 4 studies showed an improvement in the discriminant ability by 8% (95% CI: 2%-14%) when MR-proADM was added to CURB-65/CRB-65. Studies that reported long-term prognosis indicated an increased risk of death in patients with elevated MR-proADM. Conclusion Elevated level of MR-proADM is significantly associated with both short-term mortality and complications in patients with CAP. Studies also indicate that MR-proADM has prognostic value for prediction of long-term mortality in these patients. The addition of MR-proADM improves the discriminant ability of CURB-65/CRB-65.
Original language | English (US) |
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Pages (from-to) | 1569-1580 |
Number of pages | 12 |
Journal | Respiratory Medicine |
Volume | 108 |
Issue number | 11 |
DOIs | |
State | Published - Nov 1 2014 |
Externally published | Yes |
Keywords
- Epidemiology
- Meta-analysis
- Pneumonia
- Prognosis
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine