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

Patients admitted to hospital with an infection have their National Early Warning Score (NEWS) monitored. This standardised system, developed by the Royal College of Physicians, helps clinicians predict if patients are at risk of complications such as sepsis. However extra tests need to be developed as the NEWS does 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 CE-marked 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 NEWS to help assess people admitted to hospital with infections. The study took place at the Medical Admissions Suite of the Royal Victoria Infirmary in Newcastle Upon Tyne in 2015.

Progress

Our results indicated that measuring MR-proADM alongside NEWS predicts deterioration more accurately than NEWS score alone in patients who are mildly or moderately ill. The prediction was more accurate in patients without Chronic Obstructive Pulmonary Disease or Heart Failure.

Impact

• The MR-proADM test is now available and being used in several NHS centres.
• The test could help clinicians make decisions and allow patients to be transferred earlier to high dependency and intensive care units.
• 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