J. Clin. Med. 2014, 3(1), 267-279; doi:10.3390/jcm3010267
Article

Effectiveness of Proadrenomedullin Enhanced CURB65 Score Algorithm in Patients with Community-Acquired Pneumonia in “Real Life”, an Observational Quality Control Survey

1,†email, 1,†email, 1email, 1email, 1email, 1email, 1email, 1email, 2email, 2email, 1email, 2email, 1email, 1email, 3email, 4email, 5email, 1email and 6,* email
Received: 31 December 2013; in revised form: 13 February 2014 / Accepted: 18 February 2014 / Published: 14 March 2014
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Abstract: Background: An intervention trial found a trend for shorter length of stay (LOS) in patients with community-acquired pneumonia (CAP) when the CURB65 score was combined with the prognostic biomarker proadrenomedullin (ProADM) (CURB65-A). However, the efficacy and safety of CURB65-A in real life situations remains unclear. Methods: From September, 2011, until April, 2012, we performed a post-study prospective observational quality control survey at the cantonal Hospital of Aarau, Switzerland of consecutive adults with CAP. The primary endpoint was length of stay (LOS) during the index hospitalization and within 30 days. We compared the results with two well-defined historic cohorts of CAP patients hospitalized in the same hospital with the use of multivariate regression, namely 83 patients in the observation study without ProADM (OPTIMA I) and the 169 patients in the intervention study (OPTIMA II RCT). Results: A total of 89 patients with confirmed CAP were included. As compared to patients with CURB65 only observed in the OPTIMA I study, adjusted regression analysis showed a significant shorter initial LOS (7.5 vs. 10.4 days; −2.32; 95% CI, −4.51 to −0.13; p = 0.04) when CURB65-A was used in clinical routine. No significant differences were found for LOS within 30 days. There were no significant differences in safety outcomes in regard to mortality and ICU admission between the cohorts. Conclusion: This post-study survey provides evidence that the use of ProADM in combination with CURB65 (CURB65-A) in “real life” situations reduces initial LOS compared to the CURB65 score alone without apparent negative effects on patient safety.
Keywords: biomarkers; proadrenomedullin; clinical scores; CURB65; pneumonia
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.

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MDPI and ACS Style

Widmer, D.; Drozdov, D.; Rüegger, K.; Litke, A.; Arici, B.; Regez, K.; Guglielmetti, M.; Schild, U.; Conca, A.; Schäfer, P.; Kouegbe, R.B.; Reutlinger, B.; Blum, C.; Schuetz, P.; Irani, S.; Huber, A.; Bürgi, U.; Müller, B.; Albrich, W.C. Effectiveness of Proadrenomedullin Enhanced CURB65 Score Algorithm in Patients with Community-Acquired Pneumonia in “Real Life”, an Observational Quality Control Survey. J. Clin. Med. 2014, 3, 267-279.

AMA Style

Widmer D, Drozdov D, Rüegger K, Litke A, Arici B, Regez K, Guglielmetti M, Schild U, Conca A, Schäfer P, Kouegbe RB, Reutlinger B, Blum C, Schuetz P, Irani S, Huber A, Bürgi U, Müller B, Albrich WC. Effectiveness of Proadrenomedullin Enhanced CURB65 Score Algorithm in Patients with Community-Acquired Pneumonia in “Real Life”, an Observational Quality Control Survey. Journal of Clinical Medicine. 2014; 3(1):267-279.

Chicago/Turabian Style

Widmer, Daniel; Drozdov, Daniel; Rüegger, Kristina; Litke, Alexander; Arici, Birsen; Regez, Katharina; Guglielmetti, Merih; Schild, Ursula; Conca, Antoinette; Schäfer, Petra; Kouegbe, Rita B.; Reutlinger, Barbara; Blum, Claudine; Schuetz, Philipp; Irani, Sarosh; Huber, Andreas; Bürgi, Ulrich; Müller, Beat; Albrich, Werner C. 2014. "Effectiveness of Proadrenomedullin Enhanced CURB65 Score Algorithm in Patients with Community-Acquired Pneumonia in “Real Life”, an Observational Quality Control Survey." J. Clin. Med. 3, no. 1: 267-279.

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