MR-proADM can provide an immediate risk assessment of both microbial and non-microbial infections, as well as an early and accurate warning of the development of additional, adverse complications such as nosocomial infections and organ dysfunction and failure. This added information can help transfer patients into the ICU at the most appropiate time to ensure maximal patient safety, as well as aid in the earliest and safest transfer out of the ICU, when there is no further risk to the patient's health.
The importance of an accurate risk assessment and prognostic indicator to guide patient management
Sepsis, severe sepsis, and septic shock are the increasingly severe stages of an uncontrolled, systemic inflammatory host response to a bloodstream infection1, 2, and depending on the level of severity, the mortality rate can reach up to 54 %3. Extremely elevated PCT levels, which reflect the severity of a bacterial infection, can be used to guide subsequent antibiotic treatment and may indicate a high risk of organ dysfunction. However, septic patients with low or decreasing levels of PCT can also often succumb to additional unforeseen complications caused by the original septic condition. Indeed, a study of nearly 500,000 patients in the US indicated that those suffering from an initially less severe sepsis were shown to make up the majority of sepsis related deaths4. Accordingly, it can often be difficult to determine which patients will develop short-term complications in the ICU, including mortality, based on diagnostic biomarker levels and clinical signs alone.
A combination of PCT with an additional risk assessment and prognostic aid, which focuses on the overall condition of the patient independently of the infection, can maximize patient safety and physician confidence in guiding the appropriate therapy and treatment8.
Compared to existing risk assessment and biomarker scores, MR-proADM provides a more accurate and rapid risk assessment of the patient’s septic condition in both the ED and ICU9-12, as well as additionally assessing the risk of developing further clinical complications which might arise as a result of the original septic condition, which can include blood clot formation, tissue death, hypoxia, impaired organ blood flow, and ultimately, organ dysfunction and failure. Indeed, tissue hypoxia may occur even when normal organ blood flow is observed, making it extremely difficult to detect13. Increased MR-proADM levels can reflect the severity of illness with respect to comorbidities and multi-organ dysfunction syndrome (MODS), which may not be accurately reflected by diagnostic biomarker levels or conventional clinical signs, in the optimal timeframe.
Therefore, a combination of a PCT and MR-proADM can maximize patient safety by accurately assessing the immediate risk of the septic infection to their health, by highlighting any additional complications caused by the original infection, as well as providing peace of mind concerning the patient’s short- to mid-term prognosis.