Presepsin as a Potential Prognostic Marker for Sepsis According to Actual Practice Guidelines

Abstract

The 2016 Surviving Sepsis Campaign guidelines define sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection. This study had the objective of assessing the efficacy of presepsin in the prognosis of sepsis. This was a single-center prospective study, performed in Craiova Emergency Hospital, that included 114 patients admitted in the Intensive Care Unit (ICU) department between 2018 and 2019 fulfilling the sepsis criteria. Including criteria were: age ≥ 18, sepsis diagnosed by the Sequential Organ Failure Assessment (SOFA) score of pulmonary, abdominal, urinary, surgical or unknown origin, as well as lactate levels ≥ 2 mmol/l and need of vasopressors for mean arterial pressure (MAP) ≥ 65 mmHg, despite adequate volume resuscitations for patients with septic shock. Patients younger than 18, pregnant, immunocompromised, or with terminal illnesses were excluded. Based on disease severity, patients were distributed into two study groups: sepsis—76 patients and septic shock—38 patients. As expected, SOFA score and most of its components (PaO2/FiO2, platelets, and Glasgow Coma Score (GCS)) were significantly modified for patients with septic shock compared to those in the sepsis group and for survivors versus non-survivors. Overall death rate was 34.2%, with a significantly higher value for patients with septic shock (55.3% vs. 23.7%, p = 0.035). Sepsis marker presepsin was significantly elevated in all patients (2047 ng/mL) and significantly increased for the septic shock patients (2538 ng/mL, p < 0.001) and non-survivors (3138 ng/mL, p < 0.001). A significant correlation was identified between the SOFA score and presepsin (r = 0.883, p < 0.001). The receiver operating characteristics (ROC)-Area Under Curve (AUC) analysis showed significant prognostic values for presepsin regarding both sepsis severity (AUC = 0.726, 95% confidence interval CI = 0.635–0.806) and mortality risk (AUC = 0.861, 95%CI = 0.784–0.919). In conclusion, under the revised definition of sepsis, presepsin could be a useful marker for prognosis of sepsis severity and mortality risk. Additional data are required to confirm the value of presepsin in sepsis prognosis.

Presepsin and Procalcitonin as Potential Biomarkers for Early Diagnosis and Prognosis of Sepsis in Critically Ill Patients

“…Similar to our results, Behnes et al, found significant correlations between PS and PCT, as well as SOFA and APACHE scores, and subsequently severity of the disease [30]. In accordance with these findings, Drăgoescu et al, identified significant correlations between PS and the SOFA score and CRP [31]. Aliu-Bejtaa et al, revealed a strong correlation of PS with SOFA score, thus letting them believe that PS might be a specific sepsis biomarker [24].…”

Lemierre’s Syndrome: Case Presentation of a Rare and Possibly Life-Threatening Condition

“…A recent meta-analysis found a mortality rate of 4% [ 10 ]. Our case also met the 2001 criteria of sepsis [ 11 , 12 , 13 ].…”

Human Anthrax in Dolj County, Romania—A Series of Three Cases

“…There are authors who consider that a negative serological test does not rule out the diagnosis of anthrax if there is a characteristic clinical picture in a suggestive epidemiological context [ 8 , 18 ]. The absence of seroconversion was observed due to early treatment during infection, even in bacteriologically confirmed cases [ 8 , 12 , 19 , 20 , 21 ].…”