Yeungnam Univ J Med.  2021 Oct;38(4):318-325. 10.12701/yujm.2021.01018.

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

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, Chungnam National University School of Medicine, Daejeon, Korea

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 (33 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) scores (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 of >1,176 pg/mL (odds ratio [OR], 3.352; p<0.001), lactate levels (OR, 1.203; p=0.003), and 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.

Keyword

Biomarkers; Prognosis; Sepsis; Septic shock

Figure

  • Fig. 1. Flowchart of patients. ICU, intensive care unit.

  • Fig. 2. Vertical box-and-whiskers plots summarizing laboratory data on all bombarded construct combinations. The whiskers indicate the 5th-95th percentile: any data points outside of this are shown as dots. (A) White blood cells (WBC) counts, (B) C-reactive protein (CRP), (C) procalcitonin level, (D) presepsin levels, (E) lactate levels, and (F) the sequential organ failure assessment (SOFA) score in the survivor and non-survivor groups.

  • Fig. 3. Receiver operating characteristic (ROC) curves of the presepsin levels, procalcitonin levels, lactate levels, and the SOFA score in predicting patients’ in-hospital mortality. WBC, white blood cells; CRP, C-reactive protein; APACHE II, Acute Physiology and Chronic Health Evaluation II; SOFA, sequential organ failure assessment.


Reference

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