Accuracy of serum pro-adrenomedullin concentration in predicting sepsis at different degrees of severity

Abstract

Objective To evaluate the accuracy of serum pro-adrenomedullin(pro-ADM) concentration in predicting sepsis at different degrees of severity. Methods A total of 145 patients of both sexes, aged 18-64 yr, who were admitted to intensive care unit (ICU) of the First Hospital of Hebei Medical University from March 2015 to April 2017, with length of ICU stay>24 h, were enrolled.The patients were divided into 3 groups according to the Sequential Organ Failure Assessment (SOFA) score within 24 h after admission to ICU: 2 12 severe sepsis group (n=45). Peripheral venous blood samples were collected immediately after admission to hospital for determination of serum pro-ADM concentrations by enzyme-linked immunosorbent assay.The receiver operating characteristic (ROC) curve of pro-ADM in predicting sepsis at different degrees of severity was plotted, and the area under the curve and 95% confidence interval, cut-off value, sensitivity and specificity were calculated. Results The serum pro-ADM concentrations were significantly increased with the severity of sepsis, and the length of ICU stay was prolonged with the severity of sepsis (P<0.05). In mild sepsis group, the area under the ROC curve was 0.770, 95% confidence interval 0.591-0.949, sensitivity 0.725, specificity 0.700 and cut-off value 6.45 nmol/L.In moderate sepsis group, the area under the ROC curve was 0.776, 95% confidence interval 0.645-0.907, sensitivity 0.813, specificity 0.760, cut-off value 8.30 nmol/L.In severe sepsis group, the area under the ROC curve was 0.83, 95% confidence interval 0.715-0.963, sensitivity 0.73, specificity 0.800, cut-off value 5.70 nmol/L. Conclusion Serum pro-ADM concentration can be used as a reliable index in predicting sepsis at different degrees of severity. Key words: Adrenomedullin; Sepsis