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Abstract
Context: Acute dyspnea is a frequent complaint in patients attending the emergency department (ED).
Objective: To evaluate the accuracy of PCT, MR-proANP, MR-proADM, copeptin and CT-proET1 for the risk-stratification of severe acute dyspnea patients presenting to the ED.
Methods: Multicenter prospective study in adult patients with a chief complaint of acute dyspnea. Pro-hormone type biomarkers concentrations were measured on arrival. Combined primary endpoint was a poor outcome.
Results: Three hundred and ninety-four patients were included, 137 (35%) met the primary endpoint. MR-proADM was the only biomarker associated with the primary endpoint (odds ratio 1.43 [95%CI: 1.13–1.82], p = 0.003) as were the presence of paradoxical abdominal breathing (odds ratio 2.48 [95%CI: 1.31–4.68]) or cyanosis (odds ratio 3.18 [1.46–6.89])
Conclusions: In patients with severe acute dyspnea in the ED, pro-hormone type biomarkers measurements have a low added value to clinical signs for the prediction of poor outcome.
Acknowledgements
We thank Dr. David Baker DM, FRCA, (Department of Anesthesiology and Critical Care, Hôpital Necker-Enfants Malades, Paris) for reviewing the manuscript and Dr. Yannick Le Manach, MD, PhD (Departments of Anesthesia & Clinical Epidemiology and Biostatistics Michael DeGroote School of Medicine Faculty of Health Sciences, McMaster University, Canada) for statistical advice.
Disclosure statement
All remaining coauthors have no conflict of interest to declare.
Funding information
PH, YF and BR received research funds from ThermoFisher Scientific. PH and LMJ received lectures honoraria’s from ThermoFisher Scientific. ThermoFisher Scientific BRAHMS Biomarkers (Henningsdorf, Germany) provided the biomarker assays free of charge, and funded the charges for the eCRF and for the clinical research assistants dedicated to data management. The funder had no role in the study design, data collection, analysis or interpretation, or of the writing of the report.