MR-proADM in LRTI

More accurate risk assessment of Lower Respiratory Tract InfectionsThe use of MR-proADM in infectious patients with community acquired pneumonia can optimize the identification of individuals at a high clinical risk as well as those with a high risk of developing adverse complications. Accordingly, clinicians can accurately determine the most appropriate site of treatment, whilst decreasing the number of patients who develop adverse complications.

 

Lower respiratory tract infections: More accurate risk assessment and site of treatment accuracy is urgently needed

Lower respiratory tract infections (LRTIs), which include community acquired pneumonia (CAP), chronic obstructive pulmonary disease (COPD) and acute bronchitis, are amongst the most frequent causes of hospitlisation1, with as many as 40 % of elderly CAP patients being hospitalized on arrival2, and an in-hospital COPD mortality rate of between 6-8 %3.

The initial assessment of disease severity and prediction of outcome is of extreme importance, in both clinical and financial terms, since it directly influences a patient’s site of treatment. Indeed, in-patient care can cost between 8 and 20 times more than out-patient treatment4, 5, depending on treatment location, with additional risks of nosocomial complications6. Consequently, risk assessment scoring systems such as the Pneumonia Severity Index (PSI) and CURB-65 for CAP, as well as BODE for COPD, have been developed to identify patients who are at risk of dying within 30 days of hospitalisation7, 8.

However, these tools are not exempt from providing false positive or negative results, nor do they fully quantify a patient’s need for initial hospitalization or more intensive care, or accurately determine the most appropriate site for treatment.

The importance of accurate risk assessment directly influences factors such as: Overall admission rates and treatment strategy; Length of stay (LOS) and determination of treatment location;  Allocation of healthcare resources; Therapeutic option guidance

 

The solution

Using these tools alone, significant numbers of patients may be admitted as in-patients in the emergency department or intensive care units when a less intensive treatment is adequate, thus placing additional burden and cost on the hospital. On the other hand, others may be discharged prematurely when a more intensive course of action is required, consequently putting patient safety at risk.

In combination with current risk assessment scores, biomarkers can serve as an additional tool in order to further improve risk assessment score accuracy, and more accurately determine the most appropriate site of care. Of the biomarkers currently available, MR-proADM best correlates to disease severity, the risk of developing adverse complications, and short- and mid-term mortality in lower tract respiratory infections, especially when combined with such risk assessment scores9-11.

A combination approach ultimately provides the physician with a more powerful risk assessment tool, allowing better decisions to be made regarding a patient’s health, and potentially resulting in an overall economic benefit to the hospital.

Benefits of accurate risk assessment: Reduction in the risk of associated healthcare infections and nosocomial complications; Greater availability of in demand resources, such as ED and ICU beds and physician time; Reduced financial costs compared to in-patient treatment; Increased patient satisfaction and comfort

 

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