BACKGROUND: The aim of this study was to determine the prognostic utility of serial measurement of the cardiovascular biomarker midregion proadrenomedullin (MR-proADM) in patients admitted with lower respiratory tract infection. In a previous trial in dyspneic patients (BACH trial) we could show that serial measurement of MR-proADM proves useful for risk assessment and patient monitoring. Models designed to evaluate serial biomarker measurements usually fail to answer two fundamental questions necessary to judge their clinical relevance: whether serial measurements provide additional information on top of the first measurement, and, if yes, at which time point a re-evaluation may be clinically useful. METHOD: We apply an adapted time-dependent Cox model to data from the ProHosp trial, a prospective trial, which was observational in regards to application of prognostic biomarkers, where blood draws for biomarker evaluation were collected at day of patient inclusion, days 3, 5 and 7. In this trial, the cardiovascular biomarker MR-proADM was evaluated for its ability to predict survival in comparison to clinical risk scores. RESULTS: With the adapted time-dependent Cox model, we could demonstrate a significant added value of the follow up measurements on top of that obtained on admission. Despite a high correlation between serial measurements, the gain can be observed as early as 3 days after inclusion. We illustrate the added prognostic value and clinical relevance of re-evaluation via Kaplan-Meier plots. CONCLUSION: We could demonstrate that the prognostic biomarker MR-proADM can potentially serve as a outcome monitoring marker in patients admitted with lower respiratory tract infections.
RCT Entities:
BACKGROUND: The aim of this study was to determine the prognostic utility of serial measurement of the cardiovascular biomarker midregion proadrenomedullin (MR-proADM) in patients admitted with lower respiratory tract infection. In a previous trial in dyspneic patients (BACH trial) we could show that serial measurement of MR-proADM proves useful for risk assessment and patient monitoring. Models designed to evaluate serial biomarker measurements usually fail to answer two fundamental questions necessary to judge their clinical relevance: whether serial measurements provide additional information on top of the first measurement, and, if yes, at which time point a re-evaluation may be clinically useful. METHOD: We apply an adapted time-dependent Cox model to data from the ProHosp trial, a prospective trial, which was observational in regards to application of prognostic biomarkers, where blood draws for biomarker evaluation were collected at day of patient inclusion, days 3, 5 and 7. In this trial, the cardiovascular biomarker MR-proADM was evaluated for its ability to predict survival in comparison to clinical risk scores. RESULTS: With the adapted time-dependent Cox model, we could demonstrate a significant added value of the follow up measurements on top of that obtained on admission. Despite a high correlation between serial measurements, the gain can be observed as early as 3 days after inclusion. We illustrate the added prognostic value and clinical relevance of re-evaluation via Kaplan-Meier plots. CONCLUSION: We could demonstrate that the prognostic biomarker MR-proADM can potentially serve as a outcome monitoring marker in patients admitted with lower respiratory tract infections.
Authors: Soumya Banerjee; Ghislain N Sofack; Daniela Zöller; Tom R P Bishop; Thodoris Papakonstantinou; Demetris Avraam; Paul Burton Journal: BMC Res Notes Date: 2022-06-03
Authors: Heli Tolppanen; Mercedes Rivas-Lasarte; Johan Lassus; Jordi Sans-Roselló; Oliver Hartmann; Matias Lindholm; Mattia Arrigo; Tuukka Tarvasmäki; Lars Köber; Holger Thiele; Kari Pulkki; Jindrich Spinar; John Parissis; Marek Banaszewski; Jose Silva-Cardoso; Valentina Carubelli; Alessandro Sionis; Veli-Pekka Harjola; Alexandre Mebazaa Journal: Ann Intensive Care Date: 2017-01-04 Impact factor: 6.925
Authors: Kordo Saeed; Darius Cameron Wilson; Frank Bloos; Philipp Schuetz; Yuri van der Does; Olle Melander; Pierre Hausfater; Jacopo M Legramante; Yann-Erick Claessens; Deveendra Amin; Mari Rosenqvist; Graham White; Beat Mueller; Maarten Limper; Carlota Clemente Callejo; Antonella Brandi; Marc-Alexis Macchi; Nicholas Cortes; Alexander Kutz; Peter Patka; María Cecilia Yañez; Sergio Bernardini; Nathalie Beau; Matthew Dryden; Eric C M van Gorp; Marilena Minieri; Louisa Chan; Pleunie P M Rood; Juan Gonzalez Del Castillo Journal: Crit Care Date: 2019-02-08 Impact factor: 9.097