Prognostic Role of Mid-Regional Proadrenomedullin in Patients Undergoing Emergency Laparotomy: An Exploratory Study.

Authors

Deepak Singla, Sanjay Agrawal, Ranjeeta Kumari, Manisha Naithani, Priya Thayyile Kandy, Shreya Singh, Mishu Mangla

Published in

Cureus. Volume 18. Issue 8. Pages e114064. Epub Aug 06, 2026.

Abstract

Our primary objective was to determine the ability of mid-regional proadrenomedullin (MR-proADM) levels to predict outcomes, i.e., mortality and clinical cure within 30 days in post-laparotomy patients. The secondary objective was to correlate MR-proADM with other markers of sepsis, such as procalcitonin (PCT) and lactate, and to determine the ability of MR-proADM levels to predict the presence or absence of sepsis on preoperative days 3, 5, and 7 in post-laparotomy patients.  Methods: This was a single-center prospective pilot observational study. Patients ≥18 years of age who underwent emergency laparotomy (EL) under general anesthesia at a tertiary care hospital between January 2022 and July 2023 were enrolled. MR-proADM, lactate, PCT, and sequential organ failure assessment (SOFA) scores were measured pre-operatively and on days 3, 5, and 7. Detection of sepsis, clinical cure, and 30-day all-cause mortality were ascertained.
MR-proADM demonstrated statistically significant correlation with PCT (p<0.001) at all time points, the SOFA score at preoperative, day 5, and day 7, and lactate on day 7 (p<0.001). MR-proADM levels were higher on days 5 and 7 in patients who failed to achieve clinical cure (p=0.0003 and 0.0004, respectively). At all time points, the discriminatory ability of MR proADM to distinguish sepsis from non-sepsis was good. A comparison of MR-proADM levels in patients with 30-day all-cause mortality was performed. The non-survivors had significantly elevated MR-proADM levels at all time points.
MR-proADM is a valuable biomarker that correlates strongly with lactate, PCT, and the SOFA score and can help detect sepsis. Persistently higher values were associated with absence of clinical cure and 30-day all-cause mortality in patients undergoing EL.

PMID:
42701834
Bibliographic data and abstract were imported from PubMed on 06 Sep 2026.

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