Ana Maria Navio Serano1, Joaquín Valle Alonso2, Gustavo Rene Piñero3, Alejandro Rodriguez Camacho4, Josefa Soriano Benet5, Manuel Vaquero6. 1. Department of Emergency Medicine, San Pablo University, Madrid, Spain. 2. Department of Emergency Medicine, Royal Bournemouth Hospital, Bournemouth, UK. 3. Department of Emergency Medicine, Hospital Leonidas Lucero. Bahia Blanca. Buenos Aires, Argentina. 4. Department of Emergency Medicine, Hospital Puerta del Mar, Cadiz, Spain. 5. Department of Emergency Medicine. Hospital Consorcio General, Valencia, Spain. 6. Department of Family Medicine, Jean Health Centre, PC 23003, Jaén, Spain.
Abstract
OBJECTIVE: To investigate the prognostic value of clinical and laboratory tests in prediction of outcome in patients at day 30 post presentation to hospital with shock and to determine the prognostic value of mid regional pro-adrenomedullin (MR-proADM) on mortality prediction at 30 days in the same patient cohort. METHOD: This prospective multicenter cohort study analyzed data from patients who had presenting with shock to the emergency departments of eleven urban, tertiary-care University hospitals in Spain between March, 2011 and May, 2011. Recruitment of patients was via convenience sampling. Inclusion criteria included age between 14 and 100 years with clinical diagnostic criteria of shock on admission. Various patient parameters were analysed, such as age, sex, past medical history. Other clinical variables were measured on arrival to hospital, including sequential organ failure assessment score (score SOFA), blood pressure, oxygen saturations, capillary refill time and shock index (SI). Laboratory variables investigated included base excess, MR-proADM, lactate, C-Reactive Protein (CRP) and procalcitonin (PCT). RESULTS: There were 212 patients included in the study from the eleven hospitals involved. The mean age was 72.2 years old and 60.4% of the patients were men. In the discriminant analysis only age, MR-proADM and PCT remained in the final discriminant equation. The separate analysis of MR-proADM showed that, in the non-survivors group, MR-proADM levels are significantly higher than those found in the group of survivors (p<0.001). CONCLUSION: Age, PCT and MR-proADM were useful to predict short-term mortality in patients presenting to the emergency department shock. This suggests that PCT and MR-proADM in combination with the most common prediction models will improve prognostic value.
OBJECTIVE: To investigate the prognostic value of clinical and laboratory tests in prediction of outcome in patients at day 30 post presentation to hospital with shock and to determine the prognostic value of mid regional pro-adrenomedullin (MR-proADM) on mortality prediction at 30 days in the same patient cohort. METHOD: This prospective multicenter cohort study analyzed data from patients who had presenting with shock to the emergency departments of eleven urban, tertiary-care University hospitals in Spain between March, 2011 and May, 2011. Recruitment of patients was via convenience sampling. Inclusion criteria included age between 14 and 100 years with clinical diagnostic criteria of shock on admission. Various patient parameters were analysed, such as age, sex, past medical history. Other clinical variables were measured on arrival to hospital, including sequential organ failure assessment score (score SOFA), blood pressure, oxygen saturations, capillary refill time and shock index (SI). Laboratory variables investigated included base excess, MR-proADM, lactate, C-Reactive Protein (CRP) and procalcitonin (PCT). RESULTS: There were 212 patients included in the study from the eleven hospitals involved. The mean age was 72.2 years old and 60.4% of the patients were men. In the discriminant analysis only age, MR-proADM and PCT remained in the final discriminant equation. The separate analysis of MR-proADM showed that, in the non-survivors group, MR-proADM levels are significantly higher than those found in the group of survivors (p<0.001). CONCLUSION: Age, PCT and MR-proADM were useful to predict short-term mortality in patients presenting to the emergency department shock. This suggests that PCT and MR-proADM in combination with the most common prediction models will improve prognostic value.
Authors: Tim C Jansen; Jasper van Bommel; Paul G Mulder; Alexandre P Lima; Ben van der Hoven; Johannes H Rommes; Ferdinand T F Snellen; Jan Bakker Journal: J Trauma Date: 2009-02
Authors: H Bryant Nguyen; Emanuel P Rivers; Bernhard P Knoblich; Gordon Jacobsen; Alexandria Muzzin; Julie A Ressler; Michael C Tomlanovich Journal: Crit Care Med Date: 2004-08 Impact factor: 7.598
Authors: David T Huang; Derek C Angus; John A Kellum; Nathan A Pugh; Lisa A Weissfeld; Joachim Struck; Russell L Delude; Matthew R Rosengart; Donald M Yealy Journal: Chest Date: 2009-04-10 Impact factor: 9.410
Authors: R P Dellinger; Mitchell M Levy; Andrew Rhodes; Djillali Annane; Herwig Gerlach; Steven M Opal; Jonathan E Sevransky; Charles L Sprung; Ivor S Douglas; Roman Jaeschke; Tiffany M Osborn; Mark E Nunnally; Sean R Townsend; Konrad Reinhart; Ruth M Kleinpell; Derek C Angus; Clifford S Deutschman; Flavia R Machado; Gordon D Rubenfeld; Steven Webb; Richard J Beale; Jean-Louis Vincent; Rui Moreno Journal: Intensive Care Med Date: 2013-01-30 Impact factor: 17.440
Authors: Caitlin W Hicks; Rakesh S Engineer; Justin L Benoit; Srinivasan Dasarathy; Robert H Christenson; William F Peacock Journal: Eur J Emerg Med Date: 2014-04 Impact factor: 2.799
Authors: Philipp Schuetz; Marcel Wolbers; Mirjam Christ-Crain; Robert Thomann; Claudine Falconnier; Isabelle Widmer; Stefanie Neidert; Thomas Fricker; Claudine Blum; Ursula Schild; Nils G Morgenthaler; Ronald Schoenenberger; Christoph Henzen; Thomas Bregenzer; Claus Hoess; Martin Krause; Heiner C Bucher; Werner Zimmerli; Beat Mueller Journal: Crit Care Date: 2010-06-08 Impact factor: 9.097