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ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 3  |  Page : 313-320

Presepsin as a predictor of sepsis outcome in comparison with procalcitonin and C-reactive protein


1 Critical Care Medicine Department, Beni Suef University, Beni Suef, Egypt
2 Critical Care Medicine Department, Cairo University, Giza, Egypt

Correspondence Address:
MD Khaled M Taema
7985 Almadeena Almonawara Street, Mokattam, Cairo 11571
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_52_18

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Introduction Identification of predicted sepsis-related mortality is important for patient stratification. We evaluated the significance of presepsin in predicting sepsis-related mortality. Patients and Methods We enrolled 83 patients with sepsis according to the SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference in a prospective observational study. Results After excluding 28 patients owing to different exclusion criteria, 55 continued the study. Their age was 58 (47–65) years old and comprised 33 (60%) males. We measured serum presepsin, procalcitonin (PCT), and C-reactive protein (CRP) on admission and 24 and 72 h later. Acute Physiology and Chronic Health Evaluation II score and capillary leak index were estimated. The primary outcome was in-hospital mortality. The median (Q1–Q3) presepsin24 and presepsin72 levels were 127.5 (835.75–2137.5) and 883 (429–1214.5) pg/ml, respectively, in survivors compared with 2321 (1264–3456) and 3421 (1900–5432) pg/ml, respectively, in nonsurvivors (P=0.01 and 0.000, respectively). The serum CRP24 and CRP72 were 123 (76–154) and 94 (42.5–127) mg/l, respectively, in survivors compared with 156 (101–201) and 187 (139–233) mg/l, respectively, in nonsurvivors (P=0.02 and 0.000, respectively). PCT72 was 111.5 (66–186.25) pg/ml in survivors compared with 231 (187–324) pg/ml in nonsurvivors (P=0.000). Presepsin0, CRP0, PCT0, and PCT24 were not significantly different between survivors and nonsurvivors (P=0.4, 0.7, 0.5, and 0.2, respectively). The Acute Physiology and Chronic Health Evaluation II score was 18 (15–20.8) in survivors compared with 21 (19–24) in nonsurvivors, (P=0.02), whereas the capillary leak index was 42 (27.6–57.7) and 42.4 (33.3–62.3) in survivors and nonsurvivors, respectively (P=0.8). The area under the curve was the highest for presepsin72 (0.918). Presepsin72 of 1262 pg/ml was seen to be 92.3% sensitive and 81.3% specific for mortality prediction. Conclusion This study showed that the serum presepsin could be a valuable biomarker for predicting in-hospital mortality in sepsis.


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