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International Journal of Pediatrics
Volume 2018, Article ID 7908148, 5 pages
https://doi.org/10.1155/2018/7908148
Research Article

Diagnostic and Prognostic Validity of Proadrenomedullin among Neonates with Sepsis in Tertiary Care Hospitals of Southern India

1Senior Resident, Department of Pediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka 575001, India
2Associate Professor, Department of Pediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka 575001, India
3Associate Professor, Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka 575001, India
4Associate Professor, Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka 575001, India
5Professor, Department of Pediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka 575001, India
6Professor and Head, Department of Pediatrics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka 575001, India

Correspondence should be addressed to Suchetha S. Rao; ude.lapinam@oar.ahtehcus

Received 25 April 2018; Revised 24 June 2018; Accepted 4 July 2018; Published 1 August 2018

Academic Editor: Francesco Porta

Copyright © 2018 Raja Kannan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis. Materials and Methods. In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis. Repeat Pro-ADM levels were estimated after 72 hours in cases. Pro-ADM levels were compared with the clinical outcome. Results and Discussion. Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml. From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis. Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml. Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival. Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality. Conclusion. Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.