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RefWorks
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BibTeX
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-
1.
Chaudhuri S, Ravindra P, Gupta N, Rao S, Kudru CU, Saravu K, 2023. Assessment of the utility of point-of-care testing incorporating ultrasound and arterial blood gas in patients with acute febrile illness in the emergency department to determine disease severity, disposition, need for ventilation and renal replacement therapy. J Emerg Trauma Shock 16: 79–85.
-
2.
Hwang H, Hwang BY, Bueno J, 2018. Biomarkers in infectious diseases. Dis Markers 2018: 8509127.
-
3.
Temmesfeld-Wollbrück B, Hocke AC, Suttorp N, Hippenstiel S, 2007. Adrenomedullin and endothelial barrier function. Thromb Haemost 98: 944–951.
-
4.
Geven C, Bergmann A, Kox M, Pickkers P, 2018. Vascular effects of adrenomedullin and the anti-adrenomedullin antibody adrecizumab in sepsis. Shock 50: 132–140.
-
5.
Bello S, Lasierra AB, Mincholé E, Fandos S, Ruiz MA, Vera E, de Pablo F, Ferrer M, Menendez R, Torres A, 2012. Prognostic power of proadrenomedullin in community-acquired pneumonia is independent of aetiology. Eur Respir J 39: 1144–1155.
-
6.
Mebazaa A, et al., 2018. Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: The prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study. Crit Care 22: 354.
-
7.
Michels M, Djamiatun K, Faradz SMH, Koenders MMJF, de Mast Q, van der Ven AJAM, 2011. High plasma mid-regional pro-adrenomedullin levels in children with severe dengue virus infections. J Clin Virol 50: 8–12.
-
8.
Jones AE, Trzeciak S, Kline JA, 2009. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med 37: 1649–1654.
-
9.
Vittinghoff E, McCulloch CE, 2007. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 165: 710–718.
-
10.
Lundberg OHM, Bergenzaun L, Rydén J, Rosenqvist M, Melander O, Chew MS, 2016. Adrenomedullin and endothelin-1 are associated with myocardial injury and death in septic shock patients. Crit Care 20: 178.
-
11.
De Montmollin E, Peoc’h K, Marzouk M, Ruckly S, Wicky PH, Patrier J, Jaquet P, Sonneville R, Bouadma L, Timsit JF, 2022. Mid-regional pro-adrenomedullin as a prognostic factor for severe COVID-19 ARDS. Antibiotics (Basel) 11: 1166.
-
12.
Caironi P, et al., 2017. Circulating biologically active adrenomedullin (bio-ADM) predicts hemodynamic support requirement and mortality during sepsis. Chest 152: 312–320.
-
13.
Kim H, Hur M, Struck J, Bergmann A, Di Somma S, 2019. Circulating biologically active adrenomedullin predicts organ failure and mortality in sepsis. Ann Lab Med 39: 454–463.
-
14.
Laterre PF, et al., 2021. Safety and tolerability of non-neutralizing adrenomedullin antibody adrecizumab (HAM8101) in septic shock patients: The AdrenOSS-2 phase 2a biomarker-guided trial. Intensive Care Med 47: 1284–1294.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1144 | 1144 | 82 |
| Full Text Views | 78 | 78 | 12 |
| PDF Downloads | 62 | 62 | 12 |
Utility of Adrenomedullin in Predicting Outcomes in Patients with Acute Febrile Illness in the Tropics: A Prospective Observational Study
Praveen Kumar Tirlangi
Praveen Kumar Tirlangi
Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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Prithvishree Ravindra
Prithvishree Ravindra
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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Rachana Bhat
Rachana Bhat
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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Vijetha Shenoy Belle
Vijetha Shenoy Belle
Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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Souvik Chaudhuri
Souvik Chaudhuri
Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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Ashwitha Bhat
Ashwitha Bhat
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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Poojashree Acharya
Poojashree Acharya
Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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Nitin Gupta
nitin.gupta@manipal.edu
Nitin Gupta
Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;
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ABSTRACT.
Acute febrile illnesses (AFI) such as dengue, leptospirosis, and scrub typhus start with fever, but some patients can deteriorate rapidly. Identifying these patients at risk is necessary to ensure early referral. The study’s objective was to assess the utility of serum adrenomedullin (ADM) as a biomarker in predicting outcomes in adult AFI patients presenting to the emergency department (ED). In this prospective observational study, all consecutive patients admitted with AFI through the ED between June 2023 and February 2024 were assessed for eligibility. Clinical and laboratory findings were noted. The serum samples sent routinely for biochemical tests were used to calculate ADM levels at admission and 48 hours later (whenever possible). Clinically relevant outcome variables were collected for all patients. The utility of ADM in predicting 7-day mortality was evaluated for primary outcome analysis using a stepwise binary logistic regression. A total of 181 patients were recruited, with dengue (n = 91, 50%) being the most common diagnosis. The median sequential organ failure assessment score at admission was 5 (IQR: 3–10). The 7-day mortality was 26 (14%, 95% CI: 9.3–19.5). The median admission ADM levels and difference in ADM levels at 48 hours were significantly higher in those who died by day 7. Adrenomedullin levels at admission were found to be an independent predictor of 7-day mortality (adjusted odds ratio: 1.002, 95% CI: 1.001–1.004, P = 0.005). High ADM levels can be used for early referral in patients with tropical AFI. There is a need to explore the utility of antibodies targeting ADM in clinical studies.
- Supplemental Materials (PDF 183.84 KB)
Author Notes
Financial support: The project was funded by a grant received from the
Disclosure: The study was initiated after permission was obtained from the Institute’s Ethical Committee (IEC 171/2023). The patients who met the eligibility criteria were recruited after receipt of informed consent from the patient or the legally authorized representative.
Current contact information: Praveen Kumar Tirlangi and Nitin Gupta, Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India, E-mails: praveen.tirlangi@manipal.edu and nitin.gupta@manipal.edu. Prithvishree Ravindra, Rachana Bhat, Ashwitha Bhat, Poojashree Acharya, Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India, E-mails: prithvishree.r@manipal.edu, rachana.kmc@manipal.edu, ashwithabhat.97@gmail.com, and acharyapooja84@gmail.com. Vijetha Shenoy Belle, Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India, E-mail: vijetha.shenoy@manipal.edu. Souvik Chaudhuri, Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India, E-mail: souvik.chaudhuri@manipal.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Chaudhuri S, Ravindra P, Gupta N, Rao S, Kudru CU, Saravu K, 2023. Assessment of the utility of point-of-care testing incorporating ultrasound and arterial blood gas in patients with acute febrile illness in the emergency department to determine disease severity, disposition, need for ventilation and renal replacement therapy. J Emerg Trauma Shock 16: 79–85.
-
2.
Hwang H, Hwang BY, Bueno J, 2018. Biomarkers in infectious diseases. Dis Markers 2018: 8509127.
-
3.
Temmesfeld-Wollbrück B, Hocke AC, Suttorp N, Hippenstiel S, 2007. Adrenomedullin and endothelial barrier function. Thromb Haemost 98: 944–951.
-
4.
Geven C, Bergmann A, Kox M, Pickkers P, 2018. Vascular effects of adrenomedullin and the anti-adrenomedullin antibody adrecizumab in sepsis. Shock 50: 132–140.
-
5.
Bello S, Lasierra AB, Mincholé E, Fandos S, Ruiz MA, Vera E, de Pablo F, Ferrer M, Menendez R, Torres A, 2012. Prognostic power of proadrenomedullin in community-acquired pneumonia is independent of aetiology. Eur Respir J 39: 1144–1155.
-
6.
Mebazaa A, et al., 2018. Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: The prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study. Crit Care 22: 354.
-
7.
Michels M, Djamiatun K, Faradz SMH, Koenders MMJF, de Mast Q, van der Ven AJAM, 2011. High plasma mid-regional pro-adrenomedullin levels in children with severe dengue virus infections. J Clin Virol 50: 8–12.
-
8.
Jones AE, Trzeciak S, Kline JA, 2009. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med 37: 1649–1654.
-
9.
Vittinghoff E, McCulloch CE, 2007. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol 165: 710–718.
-
10.
Lundberg OHM, Bergenzaun L, Rydén J, Rosenqvist M, Melander O, Chew MS, 2016. Adrenomedullin and endothelin-1 are associated with myocardial injury and death in septic shock patients. Crit Care 20: 178.
-
11.
De Montmollin E, Peoc’h K, Marzouk M, Ruckly S, Wicky PH, Patrier J, Jaquet P, Sonneville R, Bouadma L, Timsit JF, 2022. Mid-regional pro-adrenomedullin as a prognostic factor for severe COVID-19 ARDS. Antibiotics (Basel) 11: 1166.
-
12.
Caironi P, et al., 2017. Circulating biologically active adrenomedullin (bio-ADM) predicts hemodynamic support requirement and mortality during sepsis. Chest 152: 312–320.
-
13.
Kim H, Hur M, Struck J, Bergmann A, Di Somma S, 2019. Circulating biologically active adrenomedullin predicts organ failure and mortality in sepsis. Ann Lab Med 39: 454–463.
-
14.
Laterre PF, et al., 2021. Safety and tolerability of non-neutralizing adrenomedullin antibody adrecizumab (HAM8101) in septic shock patients: The AdrenOSS-2 phase 2a biomarker-guided trial. Intensive Care Med 47: 1284–1294.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1144 | 1144 | 82 |
| Full Text Views | 78 | 78 | 12 |
| PDF Downloads | 62 | 62 | 12 |