Investigation of Plasma Presepsin (sCD14-ST) Levels in Sepsis

Abstract

Introduction: In the recent years, presepsin has been defined as a biomarker useful in the early diagnosis of sepsis. We aimed to evaluate the diagnostic and prognostic value of presepsin in patients with a Systemic inflammatory response syndrome (SIRS) and sepsis. Materials and Methods: Totally 65 patients (42 patients diagnosed with the SIRS, sepsis, or septic shock, and 23 healthy controls) were included in this prospective case-control study. Results: On the first day of hospitalization, the median value of presepsin [687.5 pg/ml (115-10049 pg/ml)] in the patient group was significantly higher than the control group [71.5 pg/ml (44.1-170 pg/ml)] (p<0.001). In the sepsis and septic shock groups, presepsin levels were higher than the SIRS group (p1=0.002, p2=0.001). There was a positive correlation between the disease severity and presepsin on the first day of hospitalization and second day of the treatment (r=0.448, 0.423; p<0.001, p<0.001, respectively). When the cut-off value of presepsin was taken as 124 pg/ml for SIRS, sepsis, and septic shock for the first day of hospitalization, the sensitivity was 97.6% and the specificity was 95.7% [area under the curve (AUC): 0.996 (p<0.001)]. When the cut-off value of the presepsin on admission was 439 pg/ml, the sensitivity of the presepsin was 100% and the specificity was 57.1% in separating a sepsis from the SIRS cases [AUC: 0.772 (p<0.001)]. When the threshold level of presepsin was taken as 864 pg/ml on the first day of hospitalization, septic shock was distinguished from the sepsis and SIRS cases with 100% sensitivity and 69.4% specificity [AUC: 0.856 (p<0.001)]. Conclusion: Presepsin appears to be a useful biomarker in early diagnosis of the SIRS, sepsis, and septic shock patients in where a rapid diagnosis and treatment are known to be lifesaving.

Keywords

• biomarker
• cd14
• presepsin
• scd14-st
• sepsis