The MR-proADM test could help to identify patients with an infection who are deteriorating and at risk of sepsis.

Problem

Patients admitted to hospital with an infection are monitored using clinical scoring systems such as National Early Warning Score (NEWS). This helps clinicians predict if patients are at risk of complications such as sepsis. However the systems do not always accurately forecast whether a patient’s health is declining. This is especially the case in patients with an underlying medical condition. Levels of adrenomedullin can be higher in patients with severe infection. However adrenomedullin is unstable and difficult to measure.

Action

• Thermo Fisher Scientific has developed a test that measures mid-regional proadrenomedullin (MR-proADM) in the blood. The company states that MR-proADM is a marker for adrenomedullin level and activity.
• They funded our study to examine whether their test could be used alongside the NEWS clinical scoring system to help assess people admitted to hospital with infections.
• The study took place at the Royal Victoria Infirmary in Newcastle Upon Tyne in 2015.

Outcome

• Our results indicated that the MR-proADM test is effective at predicting outcomes for infection when used with the NEWS clinical scoring system.
• Using the test predicted outcomes more accurately in mildly or moderately ill patients than when only the clinical scoring system was used.

Impact

• The MR-proADM test is now available and being used in several NHS centres.
• Our publication of this study was cited in a Medtech innovation briefing document produced by National Institute for Health and Care Excellence (NICE). This advice document supports decision-making by NHS and social care commissioners and staff.

For more details read our publication