The perioperative presepsin as an accurate diagnostic marker of postoperative infectious complications after esophagectomy: a prospective cohort study

Takeuchi, Masashi; Yokose, Takahiro; Kawakubo, Hirofumi; Matsuda, Satoru; Irino, Tomoyuki; Fukuda, Kazumasa; Nakamura, Rieko; Wada, Norihito; Obara, Hideaki; Kitagawa, Yuko

doi:10.1007/s10388-020-00736-7

Cited by 10 publications

(21 citation statements)

References 25 publications

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“…Our study showed that presepsin levels on POD 5 and 7 were significantly associated with infectious complications. This finding supports those of previous studies that reported that gastrointestinal anastomotic leakage or surgical-site infection could be detected through upregulation of presepsin levels on POD 5 or POD 7 [ 29 , 31 , 32 ]. In our study, infectious complications occurred after a median of 9 days.…”

Section: Discussionsupporting

confidence: 92%

“…To date, several studies have shown an association between presepsin levels and postoperative infectious complications in various types of surgeries [ 29 – 32 ], including heart transplantation [ 33 ] and allogeneic hematopoietic cell transplantation [ 10 ]. However, to the best of our knowledge, this is the first preliminary study demonstrating the usefulness of presepsin in detecting infectious complications after LT.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Utility of Presepsin in Infections After Liver Transplantation: A Preliminary Study

et al. 2021

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Background Infectious complications after solid organ transplantation can be fatal, and early diagnosis and intervention are important. To the best of our knowledge, no study has examined the diagnostic utility of presepsin, a known accurate biomarker, for infectious complications after liver transplantation. This study aimed to evaluate the utility of presepsin for detecting infection and perioperative kinetics of presepsin after liver transplantation. Material/Methods This single-institutional prospective, observational study included 13 patients who underwent living-donor or deceased-donor liver transplantation. Perioperative serum presepsin level was measured 6 times within a week to evaluate its association with infectious complications and compare it with procalcitonin and C-reactive protein levels and leukocyte count. Postoperatively, patients were followed up for 15 days for infectious complications. Results Five of the 13 patients developed infectious complications after liver transplantation. The median time for infection diagnosis was 9 postoperative days (25 th –75 th percentile, 7–10). Presepsin levels on 5 and 7 postoperative days were significantly higher in patients with infection than in those without ( P =0.019 and P =0.011, respectively). In receiver operating characteristic analysis, area under the curve values of presepsin on 5 and 7 postoperative days (0.881 and 0.905, respectively) were higher than those of other biomarkers. The optimal cut-off value of presepsin was 1361 pg/mL on postoperative day 5 and 1375 pg/mL on postoperative day 7. Conclusions Although this study included a small number of patients, presepsin levels on postoperative days 5 and 7 may be useful indicators for infectious complications after liver transplantation.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of Presepsin in Infections After Liver Transplantation: A Preliminary Study

et al. 2021

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“…Several meta-analyses have reported that presepsin is a valuable biomarker for sepsis 19 – 21 . However, there are few reports on the relationship between postoperative infectious complications and presepsin levels 15 – 17 , 22 , 23 . Moreover, there are only two reports on postoperative gastrointestinal surgery 15 – 17 , and to the best of our knowledge there have been no reports on postoperative gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…The presepsin levels are increased early in the development of sepsis 12 , 13 and are less sensitive to invasion, such as trauma 14 . However, few reports have examined the usefulness of presepsin as a biomarker for infectious complications after gastrointestinal surgery 15 – 17 , and there have been no relevant reports following gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

The usefulness of presepsin in the diagnosis of postoperative infectious complications after gastrectomy for gastric cancer: a prospective cohort study

Imai

Tanaka

Honda

et al. 2022

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This prospective study aimed to evaluate presepsin use as a biomarker of on postoperative infectious complications after gastrectomy, compared to C-reactive protein (CRP), white blood cells (WBCs), and neutrophils (Neuts). Overall, 108 patients were enrolled between October 2019 and December 2020. Presepsin, CRP, WBC, and Neut levels were measured preoperatively and on postoperative days (PODs) 1, 3, 5, and 7, using a postoperative morbidity survey. Grade II or higher infectious complications occurred in 18 patients (16.6%). Presepsin levels on all evaluated PODs were significantly higher in the infectious complication group than in the non-complication group (p = 0.002, p < 0.0001, p < 0.0001, and p = 0.025, respectively). The area under the curve (AUC) values were the highest for presepsin on PODs 3 and 7 (0.89 and 0.77, respectively) and similar to that of CRP, with a high value > 0.8 (0.86) on POD 5. For presepsin, the optimal cut-off values were 298 pg/mL (sensitivity, 83.3%; specificity, 83.3%), 278 pg/mL (sensitivity, 83.3%; specificity, 82.2%), and 300 pg/mL (sensitivity, 83.3%; specificity, 82%) on PODs 3, 5, and 7, respectively. Presepsin levels on PODs 3, 5, and 7 after gastrectomy is a more useful biomarker of postoperative infectious complications compared to CRP, WBCs, and Neuts, with a high sensitivity and specificity.

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“…Once a complication develops, the patient's hospitalization is prolonged, worsening the prognosis [1]. Previous studies have reported that white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), and presepsin (P-SEP) levels may be useful biomarkers for predicting postoperative complications [5][6][7][8][9][10][11][12][13]. However, standard biomarkers for predicting postoperative complications have not been established.…”

Section: Introductionmentioning

confidence: 99%

Histidine-rich glycoprotein as a novel predictive biomarker of postoperative complications in intensive care unit patients: a prospective observational study

et al. 2022

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Background Decrease in histidine-rich glycoprotein (HRG) was reported as a cause of dysregulation of the coagulation-fibrinolysis and immune systems, leading to multi-organ failure, and it may be a biomarker for sepsis, ventilator-associated pneumonia, preeclampsia, and coronavirus disease 2019. However, the usefulness of HRG in perioperative management remains unclear. This study aimed to assess the usefulness of HRG as a biomarker for predicting postoperative complications. Methods This was a single-center, prospective, observational study of 150 adult patients who were admitted to the intensive care unit after surgery. Postoperative complications were defined as those having a grade II or higher in the Clavien–Dindo classification, occurring within 7 days after surgery. The primary outcome was HRG levels in the patients with and without postoperative complications. The secondary outcome was the ability of HRG, white blood cell, C-reactive protein, procalcitonin, and presepsin to predict postoperative complications. Data are presented as number and median (interquartile range). Results The incidence of postoperative complications was 40%. The HRG levels on postoperative day 1 were significantly lower in patients who developed postoperative complications (n = 60; 21.50 [18.12–25.74] µg/mL) than in those who did not develop postoperative complications (n = 90; 25.46 [21.05–31.63] µg/mL). The Harrell C-index scores for postoperative complications were HRG, 0.65; white blood cell, 0.50; C-reactive protein, 0.59; procalcitonin, 0.73; and presepsin, 0.73. HRG was independent predictor of postoperative complications when adjusted for age, the presence of preoperative cardiovascular comorbidities, American Society of Anesthesiologists Physical Status Classification, operative time, and the volume of intraoperative bleeding (adjusted hazard ratio = 0.94; 95% confidence interval, 0.90–0.99). Conclusions The HRG levels on postoperative day 1 could predict postoperative complications. Hence, HRG may be a useful biomarker for predicting postoperative complications.

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The perioperative presepsin as an accurate diagnostic marker of postoperative infectious complications after esophagectomy: a prospective cohort study

Cited by 10 publications

References 25 publications

Diagnostic Utility of Presepsin in Infections After Liver Transplantation: A Preliminary Study

Diagnostic Utility of Presepsin in Infections After Liver Transplantation: A Preliminary Study

The usefulness of presepsin in the diagnosis of postoperative infectious complications after gastrectomy for gastric cancer: a prospective cohort study

Histidine-rich glycoprotein as a novel predictive biomarker of postoperative complications in intensive care unit patients: a prospective observational study

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