RT Journal Article SR Electronic T1 Prognostic power of proadrenomedullin in community-acquired pneumonia is independent of aetiology JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1144 OP 1155 DO 10.1183/09031936.00080411 VO 39 IS 5 A1 Salvador Bello A1 Ana B. Lasierra A1 Elisa Mincholé A1 Sergio Fandos A1 Maria Angeles Ruiz A1 Elisabeth Vera A1 Francisco de Pablo A1 Miguel Ferrer A1 Rosario Menendez A1 Antoni Torres YR 2012 UL http://erj.ersjournals.com/content/39/5/1144.abstract AB Biomarkers are useful in community-acquired pneumonia (CAP). Recently, midregional (MR) proadrenomedullin (proADM) has been shown to be of potential prognostic use. We sought to determine whether this prognostic role depends on the cause of CAP.We conducted a prospective cohort study of immunocompetent patients with CAP. Pneumonia Severity Index (PSI) and CURB-65 score (confusion (abbreviated mental test score of ≤8), urea ≥7 mol·L−1, respiratory rate ≥30 breaths·min−1, blood pressure <90 mmHg systolic or <60 mmHg diastolic, and age ≥65 yrs), blood C-reactive protein, procalcitonin, MR-proADM, and microbiological studies were systematically performed. Patients were grouped as bacterial, viral/atypical and mixed CAP, and were followed up at 30, 90 and 180 days, and 1 yr.We recruited 228 CAP patients. Identification of at least one pathogen was achieved in 155 (68%) patients. MR-proADM levels closely correlated with increasing severity scores, and showed an important predictive power for complications and short- and long-term mortality (1 yr). Its addition to PSI and CURB-65 significantly improved their prognostic accuracy. A MR-proADM cut-off of 0.646 nmol·L−1 identified 92% of patients scored as PSI classes IV and V as high risk. MR-proADM outcome prediction power was not affected by different aetiologies.MR-proADM has high short- and long-term prognostic accuracy, and increases the accuracy of clinical scores. The prognostic value of MR-proADM is not modified by different possible CAP aetiologies.