Adrenomedullin as a marker of severity in community acquired pneumonia

Abstract

Background: Stratification of the risk of mortality as well as identifying those patients most susceptible to complications due to pneumonia in the short and long-term, are key in establishing preventive strategies and optimizing treatment. Methods: Cross Sectional Observational Study. Participants: 72 children of 1month to <18 years of suspected cases of community acquired pneumonia (CAP) were included according to World health organisation (WHO) criteria of pneumonia. Samples were taken at the outset for pro-Adrenomedullin (Pro-ADM) level estimation. Correlations between final clinical outcomes (viz. ICU Stay, mortality, length of hospital stay) with Serum Pro-ADM levels were noted. Results: Significant positive correlation was seen between Pro-ADM levels (picomol/l) with duration of ICU stay (days), duration of invasive ventilation (days), duration of hospital stay (days) with correlation coefficient of 0.783, 0.778, 0.808 respectively. Pro-ADM levels at cut off point of >5.7 (picomol/l) with area under curve of 0.866 with diagnostic accuracy of 84.72% for correctly predicting severe CAP. Conclusions: We concluded that pro-ADM levels found to be high in severe/very severe pneumonia patients as per WHO criteria. Also, in our study higher levels of pro-ADM at the outset suggests need of ICU, Ventilator or longer hospital stays.