Abstract
BACKGROUND: To evaluate the prognostic accuracy of proadrenomedullin (proADM) in comparison with and in addition to the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a comprehensive geriatric assessment (CGA) to predict one-month mortality risk in older patients hospitalized with community-acquired pneumonia (CAP). METHODS: All patients aged 65 years and older, consecutively admitted to an acute geriatric ward with a diagnosis of CAP from February to July 2012. At admission and at discharge they were submitted to a standard CGA in order to calculate MPI. Moreover, plasma samples were taken at baseline and after one, three and five days of hospitalization for the analysis of pro-ADM. RESULTS: Fifty patients (mean age 86.2±7.5 years), with 31 at high risk of mortality (MPI-3) were enrolled. ProADM and MPI, both at admission and at discharge, were significant predictor of mortality. As expected, MPI at admission showed lower predictive accuracy than MPI at discharge (survival C-statistic 0.667 vs. 0.851). The addition of proADM to the MPI at admission significantly increased accuracy in predicting one-month mortality (C-statistics from 0.667 to 0.731, P=0.018 at baseline; from 0.667 to 0.733, P=0.008 at 1 day; from 0.633 to 0.724; P=0.019 at 3 days; from 0.667 to 0.828; P=0.003 at 5 days). Conversely, adding pro-ADM to the MPI at discharge did not significantly improve the model's prognostic accuracy. CONCLUSIONS: ProADM may significantly improve the prognostic accuracy of the MPI at admission in hospitalized elderly patients with CAP.
| Original language | English |
|---|---|
| Pages (from-to) | 80-85 |
| Number of pages | 6 |
| Journal | Panminerva Medica |
| Volume | 60 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 1 2018 |
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Keywords
- Aged
- Community-acquired infections
- Proadrenomedullin
- Prognosis
ASJC Scopus subject areas
- Medicine(all)
Cite this
Multidimensional Prognostic Index and pro-adrenomedullin plasma levels as mortality risk predictors in older patients hospitalized with community-acquired pneumonia : A prospective study. / Pilotto, Alberto; Dini, Simone; Veronese, Nicola; Daragjati, Julia; Miolo, Manuela; Mion, Monica M.; Fontana, Andrea; Lo Storto, Mario; Zaninotto, Martina; Bragato, Giada; Cella, Alberto; Carraro, Paolo; Addante, Filomena; Copetti, Massimiliano; Plebani, Mario.
In: Panminerva Medica, Vol. 60, No. 3, 01.09.2018, p. 80-85.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multidimensional Prognostic Index and pro-adrenomedullin plasma levels as mortality risk predictors in older patients hospitalized with community-acquired pneumonia
T2 - A prospective study
AU - Pilotto, Alberto
AU - Dini, Simone
AU - Veronese, Nicola
AU - Daragjati, Julia
AU - Miolo, Manuela
AU - Mion, Monica M.
AU - Fontana, Andrea
AU - Lo Storto, Mario
AU - Zaninotto, Martina
AU - Bragato, Giada
AU - Cella, Alberto
AU - Carraro, Paolo
AU - Addante, Filomena
AU - Copetti, Massimiliano
AU - Plebani, Mario
PY - 2018/9/1
Y1 - 2018/9/1
N2 - BACKGROUND: To evaluate the prognostic accuracy of proadrenomedullin (proADM) in comparison with and in addition to the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a comprehensive geriatric assessment (CGA) to predict one-month mortality risk in older patients hospitalized with community-acquired pneumonia (CAP). METHODS: All patients aged 65 years and older, consecutively admitted to an acute geriatric ward with a diagnosis of CAP from February to July 2012. At admission and at discharge they were submitted to a standard CGA in order to calculate MPI. Moreover, plasma samples were taken at baseline and after one, three and five days of hospitalization for the analysis of pro-ADM. RESULTS: Fifty patients (mean age 86.2±7.5 years), with 31 at high risk of mortality (MPI-3) were enrolled. ProADM and MPI, both at admission and at discharge, were significant predictor of mortality. As expected, MPI at admission showed lower predictive accuracy than MPI at discharge (survival C-statistic 0.667 vs. 0.851). The addition of proADM to the MPI at admission significantly increased accuracy in predicting one-month mortality (C-statistics from 0.667 to 0.731, P=0.018 at baseline; from 0.667 to 0.733, P=0.008 at 1 day; from 0.633 to 0.724; P=0.019 at 3 days; from 0.667 to 0.828; P=0.003 at 5 days). Conversely, adding pro-ADM to the MPI at discharge did not significantly improve the model's prognostic accuracy. CONCLUSIONS: ProADM may significantly improve the prognostic accuracy of the MPI at admission in hospitalized elderly patients with CAP.
AB - BACKGROUND: To evaluate the prognostic accuracy of proadrenomedullin (proADM) in comparison with and in addition to the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a comprehensive geriatric assessment (CGA) to predict one-month mortality risk in older patients hospitalized with community-acquired pneumonia (CAP). METHODS: All patients aged 65 years and older, consecutively admitted to an acute geriatric ward with a diagnosis of CAP from February to July 2012. At admission and at discharge they were submitted to a standard CGA in order to calculate MPI. Moreover, plasma samples were taken at baseline and after one, three and five days of hospitalization for the analysis of pro-ADM. RESULTS: Fifty patients (mean age 86.2±7.5 years), with 31 at high risk of mortality (MPI-3) were enrolled. ProADM and MPI, both at admission and at discharge, were significant predictor of mortality. As expected, MPI at admission showed lower predictive accuracy than MPI at discharge (survival C-statistic 0.667 vs. 0.851). The addition of proADM to the MPI at admission significantly increased accuracy in predicting one-month mortality (C-statistics from 0.667 to 0.731, P=0.018 at baseline; from 0.667 to 0.733, P=0.008 at 1 day; from 0.633 to 0.724; P=0.019 at 3 days; from 0.667 to 0.828; P=0.003 at 5 days). Conversely, adding pro-ADM to the MPI at discharge did not significantly improve the model's prognostic accuracy. CONCLUSIONS: ProADM may significantly improve the prognostic accuracy of the MPI at admission in hospitalized elderly patients with CAP.
KW - Aged
KW - Community-acquired infections
KW - Proadrenomedullin
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85053770894&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053770894&partnerID=8YFLogxK
U2 - 10.23736/S0031-0808.18.03408-0
DO - 10.23736/S0031-0808.18.03408-0
M3 - Article
C2 - 29546738
AN - SCOPUS:85053770894
VL - 60
SP - 80
EP - 85
JO - Panminerva Medica
JF - Panminerva Medica
SN - 0031-0808
IS - 3
ER -