Proteína C reactiva, procalcitonina y proadrenomedulina en la evolución de neumonías hospitalizadas

Résumé

Introduction: Community-acquired pneumonia (CAP) continues to be a major health problem. There are several scoring systems to predict its severity, but they have limitations. Different biomarkers have been proposed to be of assistance. Objective: To evaluate C reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (PADM) as prognostic factors to predict the outcome in CAP. Material and methods: All patients diagnosed with CAP and admitted to hospital during a period of 13 months were included in our study. Serum and EDTA plasma samples from the Emergency Unit were collected and frozen at -80 °C for biomarkers determination. Patients were divided into two groups: those who developed favorably and those with an unfavorable outcome. Clinical data for these patients were collected by reviewing their medical records. Results: The median values between both groups were found to be statistically significantly different for all three biomarkers. Areas under the ROC curve for each biomarker were: 0.67 for PCT, 0.62 for CRP and 0.74 for PADM. Selected cut-off for each biomarker with their corresponding sensitivity and specificity values were: 0.5 ng/mL (Se: 0.67/Sp: 0.61) for PCT, 150 mg/L (Se: 0.67/Sp: 0.47) for CRP and 1.2 nmol/L (Se: 0.8/Sp: 0.53) for PADM. Conclusions: The results indicate that these biomarkers could help in predicting the outcome of patients with CAP during hospitalization, with PADM being a potentially better predictor.