Summary
Prognostic value of pro-adrenomedullin and NT-proBNP in patients referred from the emergency department with influenza syndrome
Affiliation of the authors
DOI
Quote
Valero Cifuentes S, García Villalba E, Alcaraz García MJ, Muñoz Pérez Á, Piñera Salmerón P, Cano Sánchez A, et al. Prognostic value of pro-adrenomedullin and NT-proBNP in patients referred from the emergency department with influenza syndrome. Emergencias. 2019;31:180-4
Summary
Objectives.
To assess the prognostic value of procalcitonin (PTC), C-reactive protein (CRP), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and mid-regional pro-adrenomedullin (MR-proADM) in patients with influenza syndrome.
Methods.
Prospective study in patients admitted from the emergency department with influenza syndrome. Biomarker concentrations were measured in the first 24 h after admission and a test for influenza. The results were analyzed for ability to predict a hospital stay longer than 7 days, intensive care unit admission, or in-hospital death.
Results.
Ninety-eight patients were included; the prognosis of 44 (44.9%) was classified as poor. The areas under the receiving operator characteristic curve were 0.68 (95% CI, 0.56-0.80) for NT-proBNP, 0.73 (95% CI, 0.62-0.84) for MR-proADM, and nonsignificant for PCT and CRP. The following variables were independently associated with a poor prognosis: pneumonia (OR, 7.46 [95% CI, 2.08-26.73]; P=.002), heart failure (OR, 5.16 [95% CI, 1.35-19.74]; P=.016), and NT-proBNP > 580 pg/mL (OR, 4.68 [95% CI, 1.53-14.26]; P=.006). In the 53 patients with confirmed A(H1N1) influenza, only NT-proBNP was an independent predictor of prognosis (adjusted OR, 5.75 [95% CI, 1.46-
22.61]; P=.012).
Conclusions.
NT-proBNP and MR-proADM were the only biomarkers with prognostic value. Only NT-proBNP was a useful predictor in patients with confirmed influenza.
