{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:27:26Z","timestamp":1792729646074,"version":"4.5.0"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Acute febrile illnesses (AFI) such as dengue, leptospirosis, and scrub typhus start with fever, but some patients can deteriorate rapidly. Identifying these patients at risk is necessary to ensure early referral. The study\u2019s objective was to assess the utility of serum adrenomedullin (ADM) as a biomarker in predicting outcomes in adult AFI patients presenting to the emergency department (ED). In this prospective observational study, all consecutive patients admitted with AFI through the ED between June 2023 and February 2024 were assessed for eligibility. Clinical and laboratory findings were noted. The serum samples sent routinely for biochemical tests were used to calculate ADM levels at admission and 48\u2009hours later (whenever possible). Clinically relevant outcome variables were collected for all patients. The utility of ADM in predicting 7-day mortality was evaluated for primary outcome analysis using a stepwise binary logistic regression. A total of 181 patients were recruited, with dengue (<jats:italic>n<\/jats:italic> = 91, 50%) being the most common diagnosis. The median sequential organ failure assessment score at admission was 5 (IQR: 3\u201310). The 7-day mortality was 26 (14%, 95% CI: 9.3\u201319.5). The median admission ADM levels and difference in ADM levels at 48\u2009hours were significantly higher in those who died by day 7. Adrenomedullin levels at admission were found to be an independent predictor of 7-day mortality (adjusted odds ratio: 1.002, 95% CI: 1.001\u20131.004, <jats:italic>P<\/jats:italic> = 0.005). High ADM levels can be used for early referral in patients with tropical AFI. There is a need to explore the utility of antibodies targeting ADM in clinical studies.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0301","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T14:54:39Z","timestamp":1728399279000},"page":"1338-1342","source":"Crossref","is-referenced-by-count":1,"title":["Utility of Adrenomedullin in Predicting Outcomes in Patients with Acute Febrile Illness in the Tropics: A Prospective Observational Study"],"prefix":"10.4269","volume":"111","author":[{"given":"Praveen Kumar","family":"Tirlangi","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prithvishree","family":"Ravindra","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachana","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijetha","family":"Shenoy Belle","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Chaudhuri","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwitha","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poojashree","family":"Acharya","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Emerg Trauma Shock","first-page":"79","article-title":"Assessment of the utility of point-of-care testing incorporating ultrasound and arterial blood gas in patients with acute febrile illness in the emergency department to determine disease severity, disposition, need for ventilation and renal replacement therapy","volume":"16","author":"Chaudhuri","year":"2023"},{"key":"b2","series-title":"Dis Markers","first-page":"8509127","article-title":"Biomarkers in infectious diseases","volume":"2018","author":"Hwang","year":"2018"},{"key":"b3","series-title":"Thromb Haemost","first-page":"944","article-title":"Adrenomedullin and endothelial barrier function","volume":"98","author":"Temmesfeld-Wollbr\u00fcck","year":"2007"},{"key":"b4","series-title":"Shock","first-page":"132","article-title":"Vascular effects of adrenomedullin and the anti-adrenomedullin antibody adrecizumab in sepsis","volume":"50","author":"Geven","year":"2018"},{"key":"b5","series-title":"Eur Respir J","first-page":"1144","article-title":"Prognostic power of proadrenomedullin in community-acquired pneumonia is independent of aetiology","volume":"39","author":"Bello","year":"2012"},{"key":"b6","series-title":"Crit Care","first-page":"354","article-title":"Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: The prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study","volume":"22","author":"Mebazaa","year":"2018"},{"key":"b7","series-title":"J Clin Virol","first-page":"8","article-title":"High plasma mid-regional pro-adrenomedullin levels in children with severe dengue virus infections","volume":"50","author":"Michels","year":"2011"},{"key":"b8","series-title":"Crit Care Med","first-page":"1649","article-title":"The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation","volume":"37","author":"Jones","year":"2009"},{"key":"b9","series-title":"Am J Epidemiol","first-page":"710","article-title":"Relaxing the rule of ten events per variable in logistic and Cox regression","volume":"165","author":"Vittinghoff","year":"2007"},{"key":"b10","series-title":"Crit Care","first-page":"178","article-title":"Adrenomedullin and endothelin-1 are associated with myocardial injury and death in septic shock patients","volume":"20","author":"Lundberg","year":"2016"},{"key":"b11","series-title":"Antibiotics (Basel)","first-page":"1166","article-title":"Mid-regional pro-adrenomedullin as a prognostic factor for severe COVID-19 ARDS","volume":"11","author":"De Montmollin","year":"2022"},{"key":"b12","series-title":"Chest","first-page":"312","article-title":"Circulating biologically active adrenomedullin (bio-ADM) predicts hemodynamic support requirement and mortality during sepsis","volume":"152","author":"Caironi","year":"2017"},{"key":"b13","series-title":"Ann Lab Med","first-page":"454","article-title":"Circulating biologically active adrenomedullin predicts organ failure and mortality in sepsis","volume":"39","author":"Kim","year":"2019"},{"key":"b14","series-title":"Intensive Care Med","first-page":"1284","article-title":"Safety and tolerability of non-neutralizing adrenomedullin antibody adrecizumab (HAM8101) in septic shock patients: The AdrenOSS-2 phase 2a biomarker-guided trial","volume":"47","author":"Laterre","year":"2021"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/6\/article-p1338.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/6\/article-p1338.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/111\/6\/article-p1338.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T15:28:52Z","timestamp":1733326132000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/111\/6\/article-p1338.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,4]]},"references-count":14,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0301","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,4]]}}}