The initial prognostic assessment of patients with community-acquired pneumonia (CAP) has important clinical implications. We hypothesized that midregional proadrenomedullin (MR-proADM) is a valuable test for the prediction of outcomes in patients with CAP.
Methods
We performed a systemic review of the literature and a meta-analysis to evaluate the prognostic value of MR-proADM for short and long-term mortality in patients with CAP.
Results
Twelve studies were included in the systematic review. Elevated MR-proADM was associated with an increase in short-term mortality (OR = 6.8; 95% CI: 4.65–10.13; P value < 0.001) and complications (OR = 5.0; 95% CI: 3.86–6.49; P value < 0.001). The pooled analysis of 4 studies showed an improvement in the discriminant ability by 8% (95% CI: 2%–14%) when MR-proADM was added to CURB-65/CRB-65. Studies that reported long-term prognosis indicated an increased risk of death in patients with elevated MR-proADM.
Conclusion
Elevated level of MR-proADM is significantly associated with both short-term mortality and complications in patients with CAP. Studies also indicate that MR-proADM has prognostic value for prediction of long-term mortality in these patients. The addition of MR-proADM improves the discriminant ability of CURB-65/CRB-65.
