Usefulness of presepsin in predicting the prognosis of patients with sepsis or septic shock: a retrospective cohort study

Abstract

Background: The diagnosis and prediction of prognosis are important in patients with sepsis, and presepsin is helpful. In this study, we aimed to examine the usefulness of presepsin in predicting the prognosis of sepsis in Korea. Methods: Patients diagnosed with sepsis according to the sepsis-3 criteria were recruited into the study and classified into surviving and non-surviving groups based on in-hospital mortality. A total of 153 patients (32 and 121 patients with sepsis and septic shock, respectively) were included from July 2019 to August 2020. Results: Among the 153 patients with sepsis, 91 and 62 were in the survivor and non-survivor groups, respectively. Presepsin (p =0.004) and lactate (p =0.003) levels and the sequential organ failure assessment (SOFA) score (p <0.001) were higher in the non-survivor group. Receiver operating characteristic curve analysis revealed poor performances of presepsin and lactate in predicting the prognosis of sepsis (presepsin: area under the curve [AUC] =0.656, p =0.001; lactate: AUC =0.646, p =0.003). The SOFA score showed the best performance, with the highest AUC value (AUC =0.751, p <0.001). The prognostic cutoff point for presepsin was 1,176 pg/mL. Presepsin levels higher than 1,176 pg/mL (odds ratio [OR], 3.352; p <0.001), higher lactate levels (OR, 1.203; p =0.003), and higher SOFA score (OR, 1.249; p <0.001) were risk factors for in-hospital mortality. Conclusion: Presepsin levels were higher in non-survivors than in survivors. Thus, presepsin may be a valuable biomarker in predicting the prognosis of sepsis.

Presepsin as a Novel Biomarker in predicting In‐hospital Mortality in Patients With COVID‐19 Pneumonia

“…When monocytes are activated by an infectious agent, the soluble CD14 subtype, PSP, is released into the plasma. Subsequently, PSP levels continue to increase in the early stages of sepsis (Koh et al, 2021) In other words, it has been proposed that the elevation of PSP, results from a dose-response mechanism of the host-pathogen interaction, that occurs in the initial phase of the pathogen recognition, and remains elevated during several days on the basis of the disease severity (Zaninotto et al, 2020) Investigating the role of PSP in COVID patients is still an area of limited research and needs to be further investigated and understood. In the current study we retrospectively studied the serum levels of PSP in patients with COVID19 pneumonia to detect its relation to the outcome of COVID19 as well as its relation to other inflammatory biomarkers.…”

Value of Soluble CD14 (Presepsin) in Diagnosis of Bacterial Sepsis in Patients with Chronic Liver Disease

“…In severe sepsis and septic shock cases, presepsin and IL-6 have shown promise as prognostic markers Ferrarese et al 6 and Lee et al 30 . However, presepsin's diagnostic and early risk assessment capabilities have limitations 35 , and its predictive performance for sepsis outcomes varies 36 .…”

Presepsin as a Diagnostic and Prognostic Biomarker in Sepsis

“…The authors failed to detect any prognostic value presepsin measured in the first 24 h. Brodska et al [144] in 30 consecutive patients admitted for sepsis to the mixed medical-surgical ICU, showed the opposite results, i.e., that presepsin did not outperform the traditional biomarkers (PCT, CRP, lactate) in mortality prognosis in critically ill patients with sepsis and SIRS. Koh et al [145] evaluated the performance of presepsin as a biomarker for predicting in-hospital mortality in 153 patients with sepsis or sepsis shock admitted to ICU directly from ED. Although presepsin values were higher in the non-survivor compared to the survivor group, ROC analysis revealed poor performances of presepsin in predicting the prognosis of sepsis (AUC = 0.656, P = 0.001).…”