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Impact of adrenomedullin levels on clinical risk stratification and outcome in subarachnoid haemorrhage.
Gracia Arnillas, Maria Pilar; Alvarez-Lerma, Francisco; Masclans, Jose-Ramón; Roquer, Jaume; Soriano, Carolina; Manzano, Demian; Zapatero, Ans; Diaz, Yolanda; Duran, Xavi; Castellví, Andrea; Cuadrado, Elisa; Ois, Angel.
Afiliación
  • Gracia Arnillas MP; Critical Care Department, IMIM- Hospital del Mar, Barcelona, Spain.
  • Alvarez-Lerma F; IMIM (Medical Research Mar Institute), IMIM- Hospital del Mar, Barcelona, Spain.
  • Masclans JR; Critical Care Department, IMIM- Hospital del Mar, Barcelona, Spain.
  • Roquer J; IMIM (Medical Research Mar Institute), IMIM- Hospital del Mar, Barcelona, Spain.
  • Soriano C; Critical Care Department, IMIM- Hospital del Mar, Barcelona, Spain.
  • Manzano D; IMIM (Medical Research Mar Institute), IMIM- Hospital del Mar, Barcelona, Spain.
  • Zapatero A; Department of Neurology, Neurovascular Research Group, IMIM- Hospital del Mar, Barcelona, Spain.
  • Diaz Y; IMIM (Medical Research Mar Institute), IMIM- Hospital del Mar, Barcelona, Spain.
  • Duran X; Neurosurgery Department, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain.
  • Castellví A; Critical Care Department, IMIM- Hospital del Mar, Barcelona, Spain.
  • Cuadrado E; IMIM (Medical Research Mar Institute), IMIM- Hospital del Mar, Barcelona, Spain.
  • Ois A; Critical Care Department, IMIM- Hospital del Mar, Barcelona, Spain.
Eur J Clin Invest ; 50(11): e13318, 2020 Nov.
Article en En | MEDLINE | ID: mdl-32535893
PURPOSE: To use classification tree analysis to identify risk factors for nonsurvival in a neurological patients with subarachnoid haemorrhage (SAH) and to propose a clinical model for predicting of mortality. METHODS: Prospective study of SAH admitted to a Critical Care Department and Stroke Unit over a 2-year period. Middle region of pro-ADM plasma levels (MR-proADM) was measured in EDTA plasma within the first 24 hours of hospital admission using the automatic immunofluorescence test. A regression tree was made to identify prognostic models for the development of mortality at 90 days. RESULTS: Ninety patients were included. The mean MR-proADM plasma value in the samples analysed was 0.78 ± 0.41 nmol/L. MR-proADM plasma levels were significantly associated with mortality at 90 days (1.05 ± 0.51 nmol/L vs 0.64 ± 0.25 nmol/L; P < .001). Regression tree analysis provided an algorithm based on the combined use of clinical variables and one biomarker allowing accurate mortality discrimination of three distinct subgroups with high risk of 90-day mortality ranged from 75% to 100% (AUC 0.9; 95% CI 0.83-0.98). CONCLUSIONS: The study established a model (APACHE II, MR-proADM and Hunt&Hess) to predict fatal outcomes in patients with SAH. The proposed decision-making algorithm may help identify patients with a high risk of mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fragmentos de Péptidos / Precursores de Proteínas / Hemorragia Subaracnoidea / Mortalidad / Adrenomedulina Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Clin Invest Año: 2020 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fragmentos de Péptidos / Precursores de Proteínas / Hemorragia Subaracnoidea / Mortalidad / Adrenomedulina Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Clin Invest Año: 2020 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido