Usefulness of midregional pro-adrenomedullin as a marker of organ damage and predictor of mortality in patients with sepsis

•MR-proADM was the best biomarker to predict sepsis as defined by the Sepsis-3 criteria in hospitalized patients.•The cut-off point of MR-proADM of 1.8 nmol/L had the greater discriminative capacity to predict 90 days mortality.•The addition of MR-proADM to SOFA score increased the ability of SOFA to identify high risk patients. Midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP) and sepsis. In this paper, we examined the ability of MR-proADM to predict organ damage and long-term mortality in sepsis patients, compared to that of procalcitonin, C-reactive protein and lactate. This was a prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to internal service department. The association between biomarkers and 90-day mortality was assessed by Cox regression analysis and Kaplan–Meier curves. The accuracy of biomarkers for mortality was determined by area under the receiver operating characteristic curve (AUROC) analysis. A total of 148 patients with severe sepsis, according to the criteria of the campaign to survive sepsis, were enrolled. Eighty-five (57.4%) had sepsis according to the new criteria of Sepsis-3. MR-proADM showed the best AUROC to predict sepsis as defined by the Sepsis-3 criteria (AUROC of 0.771, 95% CI 0.692–0.850, p