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30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department

Background and Objective: Sepsis is a worldwide severe disease with a high incidence and mortality rate. Sepsis is a frequent cause of admission to the emergency department (ED). Although prognostic scores (Sequential Organ Failure Assessment, SOFA; New Early Warning Score, NEWS; Rapid Emergency Med...

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Autores principales: Casalboni, Silvia, Valli, Gabriele, Terlizzi, Ferdinando, Mastracchi, Marina, Fidelio, Giacomo, De Marco, Francesca, Bernardi, Caterina, Chieruzzi, Anastasia, Curcio, Alessia, De Cicco, Francesco, Colella, Nicola, Papasidero, Ilaria Dafne, Tartarone, Emanuele, Ruggieri, Maria Pia, Di Somma, Salvatore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783595/
https://www.ncbi.nlm.nih.gov/pubmed/36556987
http://dx.doi.org/10.3390/medicina58121786
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author Casalboni, Silvia
Valli, Gabriele
Terlizzi, Ferdinando
Mastracchi, Marina
Fidelio, Giacomo
De Marco, Francesca
Bernardi, Caterina
Chieruzzi, Anastasia
Curcio, Alessia
De Cicco, Francesco
Colella, Nicola
Papasidero, Ilaria Dafne
Tartarone, Emanuele
Ruggieri, Maria Pia
Di Somma, Salvatore
author_facet Casalboni, Silvia
Valli, Gabriele
Terlizzi, Ferdinando
Mastracchi, Marina
Fidelio, Giacomo
De Marco, Francesca
Bernardi, Caterina
Chieruzzi, Anastasia
Curcio, Alessia
De Cicco, Francesco
Colella, Nicola
Papasidero, Ilaria Dafne
Tartarone, Emanuele
Ruggieri, Maria Pia
Di Somma, Salvatore
author_sort Casalboni, Silvia
collection PubMed
description Background and Objective: Sepsis is a worldwide severe disease with a high incidence and mortality rate. Sepsis is a frequent cause of admission to the emergency department (ED). Although prognostic scores (Sequential Organ Failure Assessment, SOFA; New Early Warning Score, NEWS; Rapid Emergency Medicine Score, REMS) are commonly used for risk stratification in septic patients, many of these scores are of poor utility in the ED. In this setting, biomarkers are promising alternatives, easier to perform and potentially more specific. Bio-adrenomedullin (Bio-ADM) and Proenkephalin (PenKid) seem to have a key role in the development of organ dysfunctions induced by sepsis and, therefore, could help in the risk stratification of patients with sepsis at ED admission. The aim of this study was to evaluate the utility of Bio-ADM and PenKid, obtained through a point of care (POCT) device, in predicting 30 days mortality for patients presenting to the ED with sepsis. Methods and Results: In total, 177 consecutive adult patients with a diagnosis of sepsis presenting to the ED of San Giovanni Addolorata Hospital in Rome, Italy, between May 2021 and April 2022 were enrolled in this prospective observational study. For each patient, Bio-ADM and PenKid were obtained at ED admission together with SOFA, NEWS and REMS scores. Next, 30 days follow-up data were collected to evaluate patient mortality. Both biomarkers (Bio-ADM and PenKid) and clinical scores (SOFA, NEWS and REMS) were good predictors of mortality at 30 days, with Bio-ADM and REMS outperforming the others. Moreover, PenKid resulted in being linked with the worsening of kidney function. Conclusions: In patients presenting with sepsis in the ED, Bio-ADM and PenKid, evaluated with a POCT device, predicted 30-day mortality. These two biomarkers seem even more useful when integrated with clinical risk scores at ED admission.
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spelling pubmed-97835952022-12-24 30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department Casalboni, Silvia Valli, Gabriele Terlizzi, Ferdinando Mastracchi, Marina Fidelio, Giacomo De Marco, Francesca Bernardi, Caterina Chieruzzi, Anastasia Curcio, Alessia De Cicco, Francesco Colella, Nicola Papasidero, Ilaria Dafne Tartarone, Emanuele Ruggieri, Maria Pia Di Somma, Salvatore Medicina (Kaunas) Article Background and Objective: Sepsis is a worldwide severe disease with a high incidence and mortality rate. Sepsis is a frequent cause of admission to the emergency department (ED). Although prognostic scores (Sequential Organ Failure Assessment, SOFA; New Early Warning Score, NEWS; Rapid Emergency Medicine Score, REMS) are commonly used for risk stratification in septic patients, many of these scores are of poor utility in the ED. In this setting, biomarkers are promising alternatives, easier to perform and potentially more specific. Bio-adrenomedullin (Bio-ADM) and Proenkephalin (PenKid) seem to have a key role in the development of organ dysfunctions induced by sepsis and, therefore, could help in the risk stratification of patients with sepsis at ED admission. The aim of this study was to evaluate the utility of Bio-ADM and PenKid, obtained through a point of care (POCT) device, in predicting 30 days mortality for patients presenting to the ED with sepsis. Methods and Results: In total, 177 consecutive adult patients with a diagnosis of sepsis presenting to the ED of San Giovanni Addolorata Hospital in Rome, Italy, between May 2021 and April 2022 were enrolled in this prospective observational study. For each patient, Bio-ADM and PenKid were obtained at ED admission together with SOFA, NEWS and REMS scores. Next, 30 days follow-up data were collected to evaluate patient mortality. Both biomarkers (Bio-ADM and PenKid) and clinical scores (SOFA, NEWS and REMS) were good predictors of mortality at 30 days, with Bio-ADM and REMS outperforming the others. Moreover, PenKid resulted in being linked with the worsening of kidney function. Conclusions: In patients presenting with sepsis in the ED, Bio-ADM and PenKid, evaluated with a POCT device, predicted 30-day mortality. These two biomarkers seem even more useful when integrated with clinical risk scores at ED admission. MDPI 2022-12-04 /pmc/articles/PMC9783595/ /pubmed/36556987 http://dx.doi.org/10.3390/medicina58121786 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Casalboni, Silvia
Valli, Gabriele
Terlizzi, Ferdinando
Mastracchi, Marina
Fidelio, Giacomo
De Marco, Francesca
Bernardi, Caterina
Chieruzzi, Anastasia
Curcio, Alessia
De Cicco, Francesco
Colella, Nicola
Papasidero, Ilaria Dafne
Tartarone, Emanuele
Ruggieri, Maria Pia
Di Somma, Salvatore
30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department
title 30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department
title_full 30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department
title_fullStr 30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department
title_full_unstemmed 30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department
title_short 30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department
title_sort 30 days mortality prognostic value of poct bio-adrenomedullin and proenkephalin in patients with sepsis in the emergency department
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783595/
https://www.ncbi.nlm.nih.gov/pubmed/36556987
http://dx.doi.org/10.3390/medicina58121786
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