Biomarkers and community acquired pneumonia (CAP) severity

To check if any biomarker can be useful to assess Community Acquired Pneumonia (CAP) severity, we studied white blood cells count (WBC), and levels of C Reactive Protein (CRP), Procalcitonin (PCT) and Proadrenomedullin (MR-proADM), as well as PSI and CURB65 scores from 228 patients with CAP, within the first 24 hours of their admission in our hospital. MR-proADM correlated better with both severity scores than other biomarkers, and was the only biomarker able to distinguish among all different risk classes of PSI score (p ROC analysis for discrimination between low risk (PSI 1-3) from high risk (PSI 4-5) CAP showed that MR-proADM had the best AUC (0.811). and could be considered a good predictor of CAP severity (see figure 1 and table 1). Optimal cut-off of MR-proADM of 0.646 nmol/L showed a sensitivity of 92.1%, specificity 55.1%, positive predictive value 76.2%, and negative predictive value 80.3% for severe CAP. MR-proADM can be helpful, together with validated clinical scores, to identify CAP severity in the first hours of patient9s management.