TY - JOUR
T1 - Cardiovascular and inflammatory biomarkers to predict short- and long-term survival in community-acquired pneumonia: Results from the German Competence Network, CAPNETZ
AU - Krüger, Stefan
AU - Ewig, Santiago
AU - Giersdorf, Sven
AU - Hartmann, Oliver
AU - Suttorp, Norbert
AU - Welte, Tobias
AU - Becker, Markus
AU - Kuhnke, Antje
AU - Lode, Hartmut
AU - Schmidt-Ioanas, Malina
AU - Bauer, Torsten
AU - Schlosser, Barbara
AU - Pletz, Matthias
AU - Pletz, Matthias
AU - Pischke, Sven
AU - Schübel, Niels
AU - Huntemann, Ingrid
AU - Lorenz, Joachim
AU - Klante, Thomas
AU - Schaberg, Tom
AU - Voigt, Konstanze
AU - Schumann, Christian
AU - Jany, Berthold
AU - Ziegler, Uwe
AU - Illmann, Torsten
AU - Wallner, Michael
AU - Weber, Michael
AU - Von Baum, Heike
AU - Barten, Grit
AU - Gosmann, Ludmilla
PY - 2010/12/1
Y1 - 2010/12/1
N2 - Rationale: Several new biomarkers are related to mortality in community-acquired pneumonia (CAP). Objectives: Aim of this study was to compare new biomarkers for the prediction of short- and long-term all-cause mortality in CAP. Methods: We enrolled 728 patients (59.0 ± 18.2 yr) with CAP. Midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), proarginin-vasopressin (copeptin), proendothelin-1 (CT-proET-1), procalcitonin (PCT), C-reactive protein, white blood cell (WBC) count, and clinical confusion, respiratory rate, blood pressure, and age over 65 years (CRB-65) score were determined on admission. Patients were followed up for 180 days. Measurements and Main Results: In patients who died of any cause within 28 and 180 days (2.5 and 5.1%, respectively), MR-proADM, MR-proANP, copeptin, CT-proET-1 and PCT as well as CRB-65 were significantly higher compared with survivors. MR-proADM had the best performance for 28 days (HR 3.67) and 180 days (HR 2.84) survival. The C index of MR-proADM for 28-day survival (0.85) was superior to MR-proANP (0.81), copeptin (0.78), CT-proET-1 (0.79), and CRB-65 (0.72) for the prediction of mortality. For prediction of mortality at 180 days, the C index of MR-proADM (0.78) was higher than that for MR-proANP (0.74), copeptin (0.73), CT-proET-1 (0.76), PCT, C-reactive protein, and white blood cells. MR-proADM was independent of CRB-65, and added prognostic information for short- and long-term mortality. MR-proADM was an independent and strong predictor of short- and long-term mortality. Conclusions: All new biomarkers were good predictors of short- and long-term all-cause mortality, superior to inflammatory markers, and at least comparable to CRB-65 score. MR-proADM showed the best performance. A combination of CRB-65 with MR-proADM might be the best predictor for mortality.
AB - Rationale: Several new biomarkers are related to mortality in community-acquired pneumonia (CAP). Objectives: Aim of this study was to compare new biomarkers for the prediction of short- and long-term all-cause mortality in CAP. Methods: We enrolled 728 patients (59.0 ± 18.2 yr) with CAP. Midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), proarginin-vasopressin (copeptin), proendothelin-1 (CT-proET-1), procalcitonin (PCT), C-reactive protein, white blood cell (WBC) count, and clinical confusion, respiratory rate, blood pressure, and age over 65 years (CRB-65) score were determined on admission. Patients were followed up for 180 days. Measurements and Main Results: In patients who died of any cause within 28 and 180 days (2.5 and 5.1%, respectively), MR-proADM, MR-proANP, copeptin, CT-proET-1 and PCT as well as CRB-65 were significantly higher compared with survivors. MR-proADM had the best performance for 28 days (HR 3.67) and 180 days (HR 2.84) survival. The C index of MR-proADM for 28-day survival (0.85) was superior to MR-proANP (0.81), copeptin (0.78), CT-proET-1 (0.79), and CRB-65 (0.72) for the prediction of mortality. For prediction of mortality at 180 days, the C index of MR-proADM (0.78) was higher than that for MR-proANP (0.74), copeptin (0.73), CT-proET-1 (0.76), PCT, C-reactive protein, and white blood cells. MR-proADM was independent of CRB-65, and added prognostic information for short- and long-term mortality. MR-proADM was an independent and strong predictor of short- and long-term mortality. Conclusions: All new biomarkers were good predictors of short- and long-term all-cause mortality, superior to inflammatory markers, and at least comparable to CRB-65 score. MR-proADM showed the best performance. A combination of CRB-65 with MR-proADM might be the best predictor for mortality.
UR - http://www.scopus.com/inward/record.url?scp=78649882826&partnerID=8YFLogxK
U2 - 10.1164/rccm.201003-0415OC
DO - 10.1164/rccm.201003-0415OC
M3 - Journal articles
C2 - 20639437
AN - SCOPUS:78649882826
SN - 1073-449X
VL - 182
SP - 1426
EP - 1434
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 11
ER -