Usefulness of Preoperative Determination of Serum MR-ProAdrenomedullin Levels to Predict the Need for Postoperative Organ Support in Abdominal Oncological Surgery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Measurement of MR-ProADM
2.3. Study Variables
2.4. Statistic Analysis
3. Results
3.1. Descriptive Data
3.2. Outcome Data (Primary Outcome)
3.3. Outcome Data (Secondary Outcome)
4. Discussion
- ○
- A preoperative value of 0.87 nmol/L in the pilot study of our group to predict the need for POS [35];
- ○
- A preoperative value of 0.85 nmol/L in the study by Golubović et al. to predict postoperative mortality in abdominal surgery [36];
- ○
- A preoperative value of 0.77 ± 0.37 nmol/L in the study of Egyed et al. [37];
- ○
- A preoperative value of 1.3 nmol/L in the study referring to the prognostic capacity of mortality after TAVI [38];
- ○
- A postoperative value of 3.2 nmol/L in the study for the prediction of mortality in the postoperative period of cardiac surgery [39].
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Surgery Group | Frequency (n) | Average Duration (Minutes) |
---|---|---|
Colorectal | 227 | 211.4 ± 78 |
Pancreatohepatobiliary | 69 | 313.0 ± 139 |
Esophagogastroduodenal | 29 | 261.7 ± 134 |
Cystectomy | 30 | 267.4 ± 80 |
Open Nephrectomy | 15 | 154.1 ± 44 |
Postoperative Organic Support | Frequency (n) | Percentage (%) |
---|---|---|
Vasoconstrictors only | 31 | 8.4% |
Mechanical ventilation only | 10 | 2.7% |
Renal replacement therapy only | 0 | 0% |
Vasoconstrictors + Mechanical ventilation | 16 | 4.3% |
Vasoconstrictors + Renal replacement therapy | 1 | 0.3% |
Mechanical ventilation + Renal replacement therapy | 1 | 0.3% |
Vasoconstrictors + Mechanical ventilation + Renal replacement therapy | 4 | 1.1% |
Diagnostic Characteristics of MR-ProADM ≥ 0.70 nmol/L | Statistical Value | IC 95% | |
---|---|---|---|
Lower Limit | Upper Limit | ||
Sensitivity | 69.84% | 56.82% | 80.43% |
Specificity | 59.93% | 54.20% | 65.42% |
Positive Predictive Value | 26.35% | 19.98% | 33.82% |
Negative Predictive Value | 90.64% | 85.56% | 94.12% |
Positive Likelihood Ratio | 1.74 | 1.41 | 2.16 |
Negative Likelihood Ratio | 0.50 | 0.34 | 0.74 |
Probability of Correct Diagnosis | 62% | 56.4% | 66.56% |
OR | IC 95% | p | |
---|---|---|---|
Age ≥ 65 years | 1.7 | 1.00–2.76 | <0.05 |
Sex | 0.6 | 0.38–1.09 | ns |
Type of surgery | 5.5 | 2.20–5.65 | <0.05 |
ASA ≥ 3 | 1.5 | 0.94–2.31 | ns |
RCRI ≥ 2 | 1.5 | 0.92–2.41 | ns |
POSSUM ≥ 28 | 4.3 | 2.40–7.87 | <0.05 |
SAS ≤ 4 | 3.9 | 2.56–5.95 | <0.05 |
MR-ProADM ≥ 0.70 nmol/L | 2.8 | 1.71–4.63 | <0.05 |
OR | IC 95% | p | |
---|---|---|---|
Age ≥ 65 years | 1.0 | 0.49–2.07 | ns |
Sex | 0.7 | 0.35–1.40 | ns |
Type of surgery | 1.2 | 0.98–1.58 | ns |
ASA ≥ 3 | 0.8 | 0.41–1.65 | ns |
RCRI ≥ 2 | 0.9 | 0.42–1.84 | ns |
POSSUM ≥ 28 | 4.4 | 2.09–9.16 | <0.05 |
SAS ≤ 4 | 5.3 | 2.30–12.4 | <0.05 |
MR-ProADM ≥ 0.70 nmol/L | 2.6 | 1.33–5.09 | <0.05 |
OR | IC 95% | p | |
---|---|---|---|
Age ≥ 65 years | 1.7 | 1.42–1.96 | <0.05 |
Sex | 0.9 | 0.71–1.15 | ns |
Type of surgery | 1.0 | 0.79–1.27 | ns |
ASA ≥ 3 | 1.9 | 1.48–2.34 | <0.05 |
RCRI ≥ 2 | 1.8 | 1.46–2.20 | <0.05 |
POSSUM ≥ 28 | 1.9 | 1.50–2.45 | <0.05 |
SAS ≤ 4 | 1.3 | 0.92–1.77 | ns |
OR | IC 95% | p | |
---|---|---|---|
Age ≥ 65 years | 3.0 | 1.85–4.99 | <0.05 |
Sex | 1.2 | 0.71–1.93 | ns |
Type of surgery | 1.2 | 0.95–1.42 | ns |
ASA ≥ 3 | 1.9 | 1.11–3.09 | <0.05 |
RCRI ≥ 2 | 1.6 | 0.88–2.98 | ns |
POSSUM ≥ 28 | 2.0 | 1.26–3.30 | <0.05 |
SAS ≤ 4 | 1.3 | 0.59–2.96 | ns |
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Ramasco Rueda, F.; Planas Roca, A.; Méndez Hernández, R.; Figuerola Tejerina, A.; Tamayo Gómez, E.; Garcia Bernedo, C.; Maseda Garrido, E.; Pascual Gómez, N.F.; de la Varga-Martínez, O. Usefulness of Preoperative Determination of Serum MR-ProAdrenomedullin Levels to Predict the Need for Postoperative Organ Support in Abdominal Oncological Surgery. J. Pers. Med. 2023, 13, 1151. https://doi.org/10.3390/jpm13071151
Ramasco Rueda F, Planas Roca A, Méndez Hernández R, Figuerola Tejerina A, Tamayo Gómez E, Garcia Bernedo C, Maseda Garrido E, Pascual Gómez NF, de la Varga-Martínez O. Usefulness of Preoperative Determination of Serum MR-ProAdrenomedullin Levels to Predict the Need for Postoperative Organ Support in Abdominal Oncological Surgery. Journal of Personalized Medicine. 2023; 13(7):1151. https://doi.org/10.3390/jpm13071151
Chicago/Turabian StyleRamasco Rueda, Fernando, Antonio Planas Roca, Rosa Méndez Hernández, Angels Figuerola Tejerina, Eduardo Tamayo Gómez, Carlos Garcia Bernedo, Emilio Maseda Garrido, Natalia F. Pascual Gómez, and Olga de la Varga-Martínez. 2023. "Usefulness of Preoperative Determination of Serum MR-ProAdrenomedullin Levels to Predict the Need for Postoperative Organ Support in Abdominal Oncological Surgery" Journal of Personalized Medicine 13, no. 7: 1151. https://doi.org/10.3390/jpm13071151
APA StyleRamasco Rueda, F., Planas Roca, A., Méndez Hernández, R., Figuerola Tejerina, A., Tamayo Gómez, E., Garcia Bernedo, C., Maseda Garrido, E., Pascual Gómez, N. F., & de la Varga-Martínez, O. (2023). Usefulness of Preoperative Determination of Serum MR-ProAdrenomedullin Levels to Predict the Need for Postoperative Organ Support in Abdominal Oncological Surgery. Journal of Personalized Medicine, 13(7), 1151. https://doi.org/10.3390/jpm13071151