A study on proadrenomedullin as a marker of severity and prognosis in community-acquired pneumonia

Objectives: This study aimed to evaluate the relationship between mid-regional ProADM (MR-proADM) levels and the severity and outcomes of CAP. In addition, the study compared the prognostic utility of MR-proADM with conventional inflammatory biomarkers such as erythrocyte sedimentation rate (ESR) and total leukocyte count (TLC). Material and Methods: A prospective hospital-based study was conducted over 2 years at a tertiary care center in North India. Fifty adult patients with CAP were included in this study. CAP severity was assessed using the confusion, urea, respiratory rate, blood pressure, and age-65 score. Baseline MR-proADM levels were measured using a sandwich immunoassay. Patient outcomes were categorized as improved or expired after 4–8 weeks of follow-up. Statistical analysis was performed using the Statistical Package for the Social Sciences version 20. Results: MR-proADM levels were significantly higher in patients with severe CAP ( P = 0.021) and in those who expired (mean 1.95 nmol/L vs. 0.85 nmol/L in survivors, P < 0.0001). Multilobar pneumonia was associated with elevated MR-proADM levels compared to unilobar pneumonia ( P = 0.017). No significant correlations were found between ESR, TLC, and patient outcomes. Conclusion: MR-proADM is a reliable biomarker for predicting CAP severity and mortality, outperforming traditional inflammatory markers. Its incorporation into clinical practice could improve risk stratification and management in CAP. Further studies with larger populations are warranted to validate these findings.