Clinical Need: Early and Safe Intensive Care Discharge
An accurate assessment of disease severity can play a crucial role in facilitating an early discharge of low severity patients to a step-down unit. A study indicated that the use of MR-proADM between days 4 and 10 after sepsis diagnosis could consistently identify greater numbers of low severity patients with a lower 28 day mortality rate than all other biomarkers and clinical scores.
Accordingly, 290 low MR-proADM severity patients could be identified on day 4, of which 27.2% were deemed as clinically stable with no further increases in MR-proADM concentration from the previous measurement. The average intensive care unit (ICU) length of stay (LOS) in these patients was 8 [7 - 10] days, with a 28 and 90 day mortality rate of 0.0% and 1.4%, respectively.
In comparison, only 43 patients were actually discharged from the intensive care unit on day 4, with a 28 and 90 day mortality rate of 2.3% and 10.0%. MR-proADM concentration analysis within the patient group found that 52.6%, 42.1% and 5.3% of patients were actually discharged from the ICU with low, intermediate and high severity concentrations, respectively, thus indicating an incomplete or insufficient treatment before discharge.
The use of MR-proADM measurements to identify low severity patients can therefore potentially facilitate a decreased intensive care unit (ICU) length of stay, and potentially drive down mortality rates and ICU readmissions.