Pierre Hausfater1,2, Yann-Erick Claessens3, Arnaud Martinage4, Luc-Marie Joly5, Jean-Yves Lardeur6, Guillaume Der Sahakian7, Claire Lemanski8, Patrick Ray1,9, Yonathan Freund1,2, Bruno Riou1,2. 1. a Sorbonne Universités UPMC-Univ Paris06, UMRS INSERM 1166, IHU ICAN , GRC BIOSFAST, Paris , France. 2. b Emergency Department, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux De Paris (APHP) , Paris , France. 3. c Centre Hospitalier Princesse Grace, Monaco. 4. d SAMU 44 CHU Hôtel-Dieu , Nantes Cedex 01 , France. 5. e Emergency Department, CHU De Rouen, Hôpital Charles Nicolle Et Faculté De Médecine De Rouen , Rouen Cedex , France. 6. f Emergency Department, CHRU Poitiers La Miletrie , Poitiers , France. 7. g Emergency Department , Hôpital Hôtel-Dieu, AP-HP , Paris Cedex 4 , France. 8. h Emergency Department , CHR Lille-Hôpital B , Lille Cedex. 9. i Emergency Department, Hôpital Tenon, AP-HP , Paris Cedex 20 , France.
Abstract
CONTEXT: Acute dyspnea is a frequent complaint in patients attending the emergency department (ED). OBJECTIVE: To evaluate the accuracy of PCT, MR-proANP, MR-proADM, copeptin and CT-proET1 for the risk-stratification of severe acute dyspnea patients presenting to the ED. METHODS: Multicenter prospective study in adult patients with a chief complaint of acute dyspnea. Pro-hormone type biomarkers concentrations were measured on arrival. Combined primary endpoint was a poor outcome. RESULTS: Three hundred and ninety-four patients were included, 137 (35%) met the primary endpoint. MR-proADM was the only biomarker associated with the primary endpoint (odds ratio 1.43 [95%CI: 1.13-1.82], p = 0.003) as were the presence of paradoxical abdominal breathing (odds ratio 2.48 [95%CI: 1.31-4.68]) or cyanosis (odds ratio 3.18 [1.46-6.89]) Conclusions: In patients with severe acute dyspnea in the ED, pro-hormone type biomarkers measurements have a low added value to clinical signs for the prediction of poor outcome.
CONTEXT: Acute dyspnea is a frequent complaint in patients attending the emergency department (ED). OBJECTIVE: To evaluate the accuracy of PCT, MR-proANP, MR-proADM, copeptin and CT-proET1 for the risk-stratification of severe acute dyspneapatients presenting to the ED. METHODS: Multicenter prospective study in adult patients with a chief complaint of acute dyspnea. Pro-hormone type biomarkers concentrations were measured on arrival. Combined primary endpoint was a poor outcome. RESULTS: Three hundred and ninety-four patients were included, 137 (35%) met the primary endpoint. MR-proADM was the only biomarker associated with the primary endpoint (odds ratio 1.43 [95%CI: 1.13-1.82], p = 0.003) as were the presence of paradoxical abdominal breathing (odds ratio 2.48 [95%CI: 1.31-4.68]) or cyanosis (odds ratio 3.18 [1.46-6.89]) Conclusions: In patients with severe acute dyspnea in the ED, pro-hormone type biomarkers measurements have a low added value to clinical signs for the prediction of poor outcome.
Authors: Claudia Gregoriano; Dominik Damm; Alexander Kutz; Daniel Koch; Selina Wolfisberg; Sebastian Haubitz; Anna Conen; Luca Bernasconi; Angelika Hammerer-Lercher; Christoph A Fux; Beat Mueller; Philipp Schuetz Journal: Respir Res Date: 2021-05-13