Acute Crit Care.  2022 Nov;37(4):527-532. 10.4266/acc.2022.00150.

Validation of presepsin measurement for mortality prediction of sepsis: a preliminary study

• Baik SM
• Park J
• Kim TY
• Choi SH
• Hong KS

• KMID: 2540140
• DOI: http://doi.org/10.4266/acc.2022.00150

Abstract

Background
Sepsis and septic shock remain the leading causes of death in critically ill patients worldwide. Various biomarkers are available to determine the prognosis and therapeutic effects of sepsis. In this study, we investigated the effectiveness of presepsin as a sepsis biomarker. Methods: Patients admitted to the intensive care unit with major or minor diagnosis of sepsis were categorized into survival and non-survival groups. The white blood cell count and serum C-reactive protein, procalcitonin, and presepsin levels were measured in all patients. Results: The study included 40 patients (survival group, 32; non-survival group, 8; mortality rate, 20%). The maximum serum presepsin levels measured during intensive care unit admission were significantly higher in the non-survival group (median [interquartile range]: 4,205.5 pg/ml [1,155.8–10,094.0] vs. 741.5 pg/ml [520.0–1,317.5], P<0.05). No statistically significant intergroup differences were observed in the maximum, minimum, and mean values of the white blood cell count, as well as serum C-reactive protein, and procalcitonin levels. Based on the receiver operating characteristic curve, the area under the curve for presepsin as a predictor of sepsis mortality was 0.764. At a cut-off value of 1,898.5 pg/ml, the sensitivity and specificity of presepsin for prediction of sepsis-induced mortality were 75.0% and 87.5%, respectively. Conclusions: Early diagnosis of sepsis and prediction of sepsis-induced mortality are important for prompt initiation of treatment. Presepsin may serve as an effective biomarker for prediction of sepsis-induced mortality and for evaluation of treatment effectiveness.

Keyword

biomarkers; mortality; presepsin; sepsis; septic shock

Figure

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  Figure 1. The receiver operating characteristic curve for maximum serum levels of biomarkers for sepsis-induced mortality prediction. The cut-off value of presepsin for sepsis-induced mortality prediction is 1,898.5 pg/ml (sensitivity, 75.0%; specificity, 87.5%). AUC: area under the curve; WBC: white blood cell; CRP: C-reactive protein; PCT: procalcitonin.

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