Prognostic value of presepsin in adult patients with sepsis: Systematic review and meta-analysis

Abstract

ObjectivePresepsin is a novel biomarker to diagnose sepsis but its prognostic value has not been comprehensively reviewed. We conducted this meta-analysis to evaluate the mortality prediction value of presepsin in sepsis.MethodsWe searched comprehensive electronic databases from PubMed, EMBASE, and Cochrane Library through September 2017 using the key words of (‘presepsin’ or ‘sCD14-ST’ or ‘soluble CD14 subtype’) and (‘sepsis’ or ‘septic shock’) and (‘prognosis’ or ‘prognostic value’ or ‘prognostic biomarker’ or ‘mortality’). We extracted the presepsin levels in survivors and non-survivors from each individual study and evaluated the standardized mean difference (SMD) using a web-based meta-analysis with the R statistical analysis program.ResultsA total of 10 studies and 1617 patients were included. Presepsin levels in the first sampling (within 24 hours) were significantly lower among survivors as compared with non-survivors: the pooled SMD between survivors and non-survivors was 0.92 (95% CI: 0.62–1.22) in the random effects model (I2 = 79%, P< 0.01). In subgroups, divided by the sepsis severity or study site, pooled SMD was consistently noting higher presepsin levels in non-survivals (P< 0.05).ConclusionThis meta-analysis demonstrates some mortality prediction value in presepsin in patients with sepsis. Further studies are needed to define the optimal cut-off point to predict mortality in sepsis.

Composite bioscore is superior to routine biomarkers and established scoring systems in predicting mortality in adult critically ill patients with secondary sepsis

“…Yang and co-authors performed systematic review and meta-analysis of prognostic value of presepsin in adult septic patients and concluded that 1 st day presepsin levels had prognostic value to predict mortality in adult patients with sepsis regardless of sepsis severity. However, they noted that further research is warranted for unified clinical information (15). In accordance with our results are findings from Behnes and co-authors, who assessed prognostic utility of presepsin in 116 critically ill septic patients (16).…”

Presepsin Levels in Experimental Sepsis and Massive Bowel Resection Models in Rats

“…Several biomarkers have been developed for the diagnosis of sepsis such as procalcitonin and C-reactive protein, but they have limitations in their use like sensitivity and specificity problems (2). Furthermore, sCD14-subtypes (presepsin) were discovered as a new biomarker for sepsis in 2004 and several studies have been conducted to delineate the importance of presepsin for early diagnosis and follow up of sepsis (13,33,34). It is well known that presepsin is produced in response to phagocytosis of bacteria in infections, however, it is not yet clear which humoral and cellular factors are responsible for the production of presepsin (13,35).…”

Sepsis diagnosis and monitoring – procalcitonin as standard, but what next?

“…Additionally, in subgroups, divided by the sepsis severity, pooled SMD for presepsin was significantly higher in non-survivors (P < 0.05). According to the authors' opinion, their results indicated some mortality prediction value of presepsin in patients with sepsis but defining the optimal cutoff point of presepsin requires further studies [38].…”

“…Yang et al [38] in adult septic patients assessed in a meta-analysis the prognostic value of presepsin. Ten studies and 1617 patients were included.…”