Hospital Admission or Outpatient Treatment?
Benefit of Thermo Scientific B·R·A·H·M·S MR-proADM KRYPTOR in reducing hospital admission shown for the first time in a randomized control trial.
Two independent observational cohort studies have previously identified MR-proADM as the best risk stratification marker. The biomarker safely and accurately supported level of care decisions.Ref-1-2
The IDEAL study, a randomised controlled trial has confirmed observational data in real life patient careRef-3. Safe hospital discharge increased by 50% using the MR-proADM guided triage.
Figure 1: Number of patients (in %) admitted with signs of infection to the ED that could be discharged for outpatient treatment, based on either clinical assessment alone (standard of care, n=99) or a combination of clinical assessment and MR-proADM value (MR-proADM based, n=86).
The algorithm of patients derivation is depicted in figure 2. Mortality: zero patients in in both groups. 14-days readmission: 3 patients (7.1%) in Standard of Care, 5 patients (9.3%) in MR-proADM based, p-value=1. 14 days representation rate: 8 patients (19.0%) in Standard of Care, 9 patients (16.7%) in MR-proADM based, p-value=0.973.
In patients with suspected infection presenting to the ED the MR-proADM algorithm can help to
- Identify patients at risk who require hospitalization (“red flag”)
- Rule-out severe conditions and increase safe discharge for up to 50% more patients compared to standard of care
- Optimize patient workflow
Presentation in the ED with suspicion of infection
Figure 2: MR-proADM guided algorithm for the triage of patients presenting to the ED with suspicion of infection as used in the IDEAL study
References hospital admission
Ref-1: Elke, G., et al., The use of mid-regional proadrenomedullin to identify disease severity and treatment response to sepsis – a secondary analysis of a large randomised controlled trial. Crit Care, 2018. 22(1): p. 79. doi: 10.1186/ s13054-018-2001-5.
Ref-2: Saeed, K., et al., The early identification of disease progression in patients with suspected infection presenting to the emergency department: a multi-centre derivation and validation study. Crit Care, 2019. 23(1): p. 40. doi: 10.1186/ s13054-019-2329-5.
Ref-3: Gonzalez del Castillo J. et al., Midregional proadrenomedullin (MR-proADM) algorithm reduces hospitalization rate by identifying low risk patients in the ED safely treatable as out-patients 2020 Poster P538 at eISICEM.