Đang chuẩn bị nút TẢI XUỐNG, xin hãy chờ
Tải xuống
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Prohormones for prediction of adverse medical outcome in community-acquired pneumonia and lower respiratory tract infections. | Schuetz et al. Critical Care 2010 14 R106 http ccforum.eom content 14 3 R106 c CRITICAL CARE RESEARCH Open Access Prohormones for prediction of adverse medical outcome in community-acquired pneumonia and lower respiratory tract infections Philipp Schuetz41 Marcel Wolbers42 3 Mirjam Christ-Crain1 Robert Thomann1 4 Claudine Falconnier1 5 Isabelle Widmer6 Stefanie Neidert6 Thomas Fricker7 Claudine Blum8 Ursula Schild1 Nils G Morgenthaler9 Ronald Schoenenberger4 Christoph Henzen6 Thomas Bregenzer8 Claus Hoess7 Martin Krause7 Heiner C Bucher2 Werner Zimmerli5 Beat Mueller 8 for the ProHOSP Study Group Abstract Introduction Measurement of prohormones representing different pathophysiological pathways could enhance risk stratification in patients with community-acquired pneumonia CAP and other lower respiratory tract infections LRTI . Methods We assessed clinical parameters and five biomarkers the precursor levels of adrenomedullin ADM endothelin-1 ET1 atrial-natriuretic peptide ANP anti-diuretic hormone copeptin and procalcitonin in patients with LRTI and CAP enrolled in the multicenter ProHOSP study. We compared the prognostic accuracy of these biomarkers with the pneumonia severity index PSI and CURB65 Confusion Urea Respiratory rate Blood pressure Age 65 score to predict serious complications defined as death ICU admission and disease-specific complications using receiver operating curves ROC and reclassification methods. Results During the 30 days of follow-up 134 serious complications occurred in 925 14.5 patients with CAP Both PSI and CURB65 overestimated the observed mortality X2 goodness of fit test P 0.003 and 0.01 . ProADM or proET1 alone had stronger discriminatory powers than the PSI or CURB65 score or any of either score components to predict serious complications. Adding proADM alone or all five biomarkers jointly to the PSI and CURB65 scores significantly increased the area under the curve AUC for PSI from 0.69 to 0.75 and for CURB65 from 0.66 to 0.73 P .
