Startseite Procalcitonin and mid-regional pro-adrenomedullin test combination in sepsis diagnosis
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Procalcitonin and mid-regional pro-adrenomedullin test combination in sepsis diagnosis

  • Silvia Angeletti EMAIL logo , Fabrizio Battistoni , Marta Fioravanti , Sergio Bernardini und Giordano Dicuonzo
Veröffentlicht/Copyright: 16. Oktober 2012
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Clinical Chemistry and Laboratory Medicine
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine Band 51 Heft 5

Abstract

Background: The early diagnosis of sepsis plays a central role in patient management. Many mediators to be the cause of sepsis have been proposed. In the present study the combined measurement of procalcitonin (PCT) and mid-regional pro-adrenomedullin (MR-proADM) and their appropriate cut-off values in sepsis patients were evaluated.

Methods: PCT and MR-proADM were measured with commercially available immunoluminometric assays (Brahms, Hennigsdorf, Germany) in 200 septic patients, 90 patients with SIRS and 30 healthy individuals. Data were analyzed with ROC curve analysis and likelihood ratios with the MedCalc 11.6.1.0 package.

Results: Healthy controls and non-infectious SIRS were clearly distinguished from sepsis patients using the following cut-off values: 0.30 ng/mL for PCT and 1 nmol/L for ADM. In the 200 septic patients the areas under the curve (AUCs) for PCT and MR-proADM were 0.921 and 0.977, respectively, with a statistically significant difference between the two areas of 0.0563 (p=0.0002). Gram-positive, Gram-negative, yeast and polymicrobial sepsis patients showed different geometric means of the two biomarkers: this difference was relevant in Gram-positive sepsis and in yeast sepsis, 0.0819 (p=0.0076) and 0.188 (p=0.0062), respectively. The combined use of PCT and MR-proADM gave a post-test probability of 0.998 in the cohort of all septic patients. By test combination the post-test probability changed from 0.803 to 0.957 in Gram-positive sepsis and from 0.928 to 0.995 in yeast sepsis.

Conclusions: In conclusion, data from this study demonstrates that the combined use of PCT and MR-proADM, may substantially improve the early diagnosis of sepsis.

Keywords: mid-regional pro-adrenomedullin; procalcitonin; sepsis
Corresponding author: Silvia Angeletti, Centro Integrato di Ricerche (CIR), Laboratory of Clinical Pathology and Microbiology, University “Campus Bio-Medico”, Via Alvaro del Portillo 200, 00128 Rome, Italy, Phone: +39 6225411112, Fax: +39 6225411456

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

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Received: 2012-9-11
Accepted: 2012-9-24
Published Online: 2012-10-16
Published in Print: 2013-05-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/cclm-2012-0595
Schlagwörter für diesen Artikel
mid-regional pro-adrenomedullin; procalcitonin; sepsis

Artikel in diesem Heft

  1. Masthead
  2. Masthead
  3. Editorial
  4. Progress towards standardization: an IFCC Scientific Division Perspective
  5. Review
  6. Quantitative Clinical Chemistry Proteomics (qCCP) using mass spectrometry: general characteristics and application
  7. Mini Reviews
  8. Analytical goals for the determination of HbA2
  9. Glucose meters – fit for clinical purpose
  10. Opinion Papers
  11. Metrological traceability – a concept for standardization in laboratory medicine
  12. Recommendations for clinical laboratory science reports regarding properties, units, and symbols: the NPU format1)
  13. “Good samples make good assays” – the problem of sourcing clinical samples for a standardization project
  14. Defining acceptable limits for the metrological traceability of specific measurands
  15. Original Articles
  16. A reference system for urinary albumin: current status
  17. Toward standardization of carbohydrate-deficient transferrin (CDT) measurements: III. Performance of native serum and serum spiked with disialotransferrin proves that harmonization of CDT assays is possible
  18. External Quality Assessment Scheme for reference laboratories – review of 8 years’ experience
  19. Utility of a panel of sera for the alignment of test results in the worldwide multicenter study on reference values
  20. Protocol and standard operating procedures for common use in a worldwide multicenter study on reference values
  21. Guidelines and Recommendations
  22. 2013 update on the worldwide standardization of the hemoglobin A1c measurement
  23. General Clinical Chemistry and Laboratory Medicine
  24. Evacuated blood-collection tubes for haematological tests – a quality evaluation prior to their intended use for specimen collection
  25. Refrigeration is not necessary for measurement of uric acid in patients treated with rasburicase
  26. Procalcitonin and mid-regional pro-adrenomedullin test combination in sepsis diagnosis
  27. Cysteinyl leukotrienes in exhaled breath condensate of smoking asthmatics
  28. Helicobacter pylori serology in autoimmune diseases – fact or fiction?
  29. Serum DNase I activity in systemic lupus erythematosus: correlation with immunoserological markers, the disease activity and organ involvement
  30. Antibodies against Nε-homocysteinylated proteins in patients on different methods of renal replacement therapy
  31. Reference Values and Biological Variations
  32. Reference values for urinary neutrophil gelatinase-associated lipocalin (NGAL) in pediatric age measured with a fully automated chemiluminescent platform
  33. High biological variation of serum hyaluronic acid and Hepascore, a biochemical marker model for the prediction of liver fibrosis
  34. Cardiovascular Diseases
  35. Circulating matrix Gla protein: a potential tool to identify minor carotid stenosis with calcification in a risk population
  36. Midregional pro-atrial natriuretic peptide in the general population/Insights from the Gutenberg Health Study
  37. Letters to the Editor
  38. Relationship between Helicobacter pylori infection and autoimmune disorders
  39. Rapid simultaneous genotyping of polymorphisms in ADH1B and ALDH2 using high resolution melting assay
  40. Comparison of biological specimens and DNA collection methods for PCR amplification and microarray analysis
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  42. Response to: Transferrin/log(ferritin) ratio: a self-fulfilling prophecy when iron deficiency is defined by serum ferritin concentration
  43. Determinants of homocysteine concentrations in mother and neonatal girl pairs
  44. Cysteine analog breaks cryoprecipitate associated with chronic hepatitis C
  45. Cut-off values of serum growth hormone (GH) in pharmacological stimulation tests (PhT) evaluated in short-statured children using a chemiluminescent immunometric assay (ICMA) calibrated with the International Recombinant Human GH Standard 98/574
  46. Normalized MEDx chart as a useful tool for evaluation of analytical quality achievements. A picture is worth a thousand words
  47. Harmonization of immunoassays to the all-procedure trimmed mean – proof of concept by use of data from the insulin standardization project
  48. Congress Abstracts
  49. Annual Assembly of the Swiss Society of Clinical Chemistry & International Congress of Porphyrins and Porphyrias & International Meeting of Porphyria Patients: Personalized Medicine and Rare Diseases
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