Asymmetric dimethylarginine predicts outcome and time of stay in hospital in patients attending an internal medicine emergency room

Abstract Introduction For patients attending the emergency room (ER) valid diagnostic criteria which identify patients at risk for an adverse outcome are needed. We investigated the predictive value of asymmetric dimethylarginine (ADMA) in unselected patients attending an internal medicine ER regarding outcome of the patients and duration of stay in the hospital. Patients and methods Patients ( n  = 417) attending the ER were classified according to their primary diagnosis. Routine laboratory tests were performed and ADMA was determined. Patients were followed for a primary endpoint of in hospital death and complicated outcome. Results ADMA levels were highest in patients with a cancer-related diagnosis (0.76 (0.63–0.93) µmol/L) and in patients with a cardiovascular diagnosis (0.69 (0.60–0.80) µmol/L; p p  = 0.007). ADMA had the highest predictive value for the primary endpoint in patients with cardiovascular disease (odds ratio 19.4; p  = 0.029). In a Cox proportional hazard model ADMA was an independent predictor of the length of hospitalization (hazard ratio 2.0 (95% CI: 1.3–3.3); p  = 0.006) in the entire cohort. Conclusion We conclude that ADMA independently predicts future complications and hospitalization in patients attending an ER.