RT Journal Article SR Electronic T1 Biomarkers as complication predictors in community-acquired pneumonia JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP p1460 VO 38 IS Suppl 55 A1 Sergio Fandos A1 Elisa Mincholé A1 Ana Lasierra A1 Ana Lilian Simon A1 Elisabeth Vera A1 Maria Angeles Ruiz A1 Salvador Bello YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/p1460.abstract AB In order to determine if some marker that can help us to predict complications in patients admitted with community-acquired pneumonia (CAP), we prospectively included 228 patients and studied leukocyte count (WBC), C-reactive protein (CRP), procalcitonin (PCT) and midregional proadrenomedullin (MR-proADM) in the first 24 hours of their arrival.One hundred and forty six (64%) patients suffered 310 significant complications within first 30 days after hospital admittance. Most frequent complications were: respiratory failure, pleural effusion, left cardiac failure, tachyarritmias, septic shock and mechanical ventilation. We found significant raised levels of MR-proADM (p<0.0001), PCT (p=0.001) and CRP (0.004) (Table 2) and in higher PSI (p<0.0001) and CURB65 (p<0.0001) scores, in patients with complications.In ROC analysis the best AUCs were PSI 0.729 and MR-proADM 0.706. The optimal cut-off to predict complications for MR-proADM was 0.833 nmol/L, (sensitivity 67.35%, specificity 66.23%, positive likelihood ratio (LHR+) 1.99 and negative likelihood ratio (LHR-) 0.49. Findings for PSI class 4 and 5, were sensitivity 72.3%, specificity 62.34%, LHR+ 1.92 and LHR- 0.44. Similar results were obtained when we compared patients with and without only respiratory complications.PCT and CRP, and especially MR-proADM and PSI score, appear to be useful in early identification of patients at risk for complications during hospitalization