Joko Susanto, - and Muhamad Robi'ul Fuadi, - and Mia Ratwita Andarsini, - (2022) Diagnostic Value of Mid Regional Proadrenomedullin as a Sepsis Biomarker in Pediatric Patients with Cancer-Related Chemotherapy. Indian Journal of Forensic Medicine & Toxicology, 16 (1). pp. 658-663. ISSN 0973-9122

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Abstract

The aim of this study was to analyze the diagnostic value of mid regional proadrenomedullin as a sepsis biomarker in pediatric patients with cancer-related chemotherapy. This cross-sectional observational study was located in General Hospital Dr. Soetomo Surabaya from September until December 2020. International Pediatric Sepsis Consensus Conference criteria was used to define sepsis term on 2 study groups. Serum mid regional proadrenomedullin has been drawn from 60 subjects (41 in-ward pediatric patients) and measured on sandwich enzyme-linked immunosorbent assay from Elabscience Human Mid Regional Proadrenomedullin. Humareader Single Plus ® was used to measure the optical density. ROC analysis was used to find out cut off value, sensitivity, specificity, positive predictive value, negative predictive value, negative likelihood ratio, positive likelihood ratio, and accuracy, respectively. Statistics declared significant if p<0.05 (95% CI). Between groups, temperature and heart rate were statistically different (p<0.001; 95% CI). The median difference of mid regional proadrenomedullin between groups was significant (p<0.05; 95% CI). Cut off value 2,88 nmol/L, sensitivity 60.0%, specificity 56.67%, positive predictive value 58.06%, negative predictive value 58.62%, positive likelihood ratio 1.38, negative likelihood ratio 0.71 and diagnostic accuracy 59.33% was obtained while area under curve was 0.707, respectively. Sepsis in children with cancer –related chemotherapy has not well diagnosed by serum mid regional proadrenomedullin.

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