Diagnostic and Prognostic Validity of Proadrenomedullin among Neonates with Sepsis in Tertiary Care Hospitals of Southern India

Abstract EN

Introduction.

To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis.

Materials and Methods.

In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis.

Repeat Pro-ADM levels were estimated after 72 hours in cases.

Pro-ADM levels were compared with the clinical outcome.

Results and Discussion.

Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml.

From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis.

Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml.

Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival.

Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality.

Conclusion.

Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.