The accuracy of presepsin for the diagnosis of sepsis from SIRS: a systematic review and meta-analysis

Abstract

BackgroundSepsis is a common condition that has a high mortality and morbidity that need prompt diagnosis and treatment. Biomarkers like Soluble CD14 subtype (sCD14-ST, presepsin) may be useful in identifying patients with sepsis and its diagnostic superiority has been confirmed by several preliminary studies. The aim of this study was systematically and quantitatively to evaluate the value of presepsin for the diagnosis of sepsis through the method of meta-analysis.MethodsFour major databases, including MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library were systematically searched from inception to March 2015. Two investigators conducted the processes of literature search, study selection, data extraction, and quality evaluation independently. And the original data were extracted from all eligible individual studies to construct two-by-two tables.ResultsA total of eight studies comprising 1757 patients were included in this meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio were 0.77 (95 % confidence interval [CI]: 0.75–0.80), 0.73 (95 % CI 0.69–0.77), and 14.25 (95 % CI 8.66–23.42), respectively. The summary receiver operating characteristic curve (SROC) area under the curve (AUC) was 0.8598. The subgroup analysis based on excluding the outliers showed that the pooled sensitivity and specificity were 0.85 (95 % CI 0.81–0.89) and 0.65 (95 % CI 0.59–0.70), respectively. The AUC was 0.8213 with no significant heterogeneity.ConclusionsPresepsin has moderate diagnostic capacity for the detection of sepsis. Further research of presepsin is needed before widespread use in emergency department. And presepsin in combination with other laboratory biomarkers in diagnosing sepsis may be the focus of future studies.

Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis

“…Performance of presepsin corresponds to those reported in non-cirrhotic septic patient populations. In a recent meta-analysis of Zheng et al[41], comprising a total of 8 studies and 1757 patients, the AUC of the summary ROC (SROC) was 0.82. In contrast, weak predictive power of CRP with an AUC-ROC of 0.64 was reported for the infections in critically ill patients with cirrhosis in intensive care unit (ICU)[22], which is also in agreement with our results.…”

Serum Presepsin Levels in Patients with Decompensated Heart Failure

“…(14,15) The wide range of PSP levels among studies may be due to the selection bias of the subjects or the method of PSP measurement. (2,16) We measured PSP with chemiluminescent enzyme immunoassay method which is the most used method in other studies.…”

Clinical Assays in Sepsis: Prognosis, Diagnosis, Outcomes, and the Genetic Basis of Sepsis

“…In ICU patients, presepsin demonstrated diagnostic capacity in differentiating sepsis severity and prognostic value in mortality [156], while Masson et al [157] found that presepsin measured on the first day in ICU in patients with severe sepsis or septic shock was higher in nonsurvivors compared to survivors, thus exhibiting useful prognostic importance. In 2015, three large meta-analyses concluded that presepsin has moderate diagnostic capacity for the detection of sepsis and it is an effective adjunct biomarker, but is insufficient to detect or rule out sepsis when used alone [158][159][160].…”