Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department
<i>Background and Objectives</i>: Presepsin (PSS) is an independent predictor for estimating disease severity and prognosis in septic patients. Few studies have reported the associations between plasma PSS and the severity and prognosis in patients with community-acquired pneumonia (CAP)...
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MDPI AG
2022-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/11/1504 |
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| author | Kyeong-Ryong Lee Dae-Young Hong Jin-Hui Paik Hyun-Min Jung |
| author_facet | Kyeong-Ryong Lee Dae-Young Hong Jin-Hui Paik Hyun-Min Jung |
| author_sort | Kyeong-Ryong Lee |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Presepsin (PSS) is an independent predictor for estimating disease severity and prognosis in septic patients. Few studies have reported the associations between plasma PSS and the severity and prognosis in patients with community-acquired pneumonia (CAP). We investigated whether a high plasma PSS level was associated with 30-day mortality in CAP patients. <i>Materials and Methods</i>: This retrospective single-center study was conducted in an emergency department. The PSS level was measured in 211 adult CAP patients admitted to the hospital and followed for up to 30 days. We recorded the pneumonia severity index (PSI) and the CURB-65 score. The primary outcome was death from any cause within 30 days. <i>Results</i>: The plasma PSS levels were significantly elevated in the high-risk group (PSI > 130) compared with the low- (PSI < 91) or moderate-risk groups (PSI 91–130). Forty-four patients (20.9%) died within 30 days of admission. Non-survivors had significantly higher plasma PSS levels than survivors among CAP patients: 1083 (697–1736) pg/mL vs. 385 (245–554) pg/mL (<i>p</i> < 0.001). The area under the curve (AUC) to predict 30-day mortality was highest for PSS (0.867), followed by procalcitonin (0.728) and lactate (0.616). The cutoff level of plasma PSS for 30-day mortality was >754 pg/mL. The combination of PSI and plasma PSS level improved the predictive ability for 30-day mortality (AUC = 0.892). Cox regression analysis showed that higher PSS levels (>754 pg/mL) and higher PSI (>126) were associated with 30-day mortality in CAP patients (hazard ratios of 19.472 and 6.375, respectively). <i>Conclusion</i>: Elevated plasma PSS is associated with severity and 30-day mortality in hospitalized CAP patients. Combining plasma PSS level and PSI could significantly improve the predictive ability of PSS for 30-day mortality. |
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| language | English |
| last_indexed | 2024-03-09T18:51:34Z |
| publishDate | 2022-10-01 |
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| series | Medicina |
| spelling | doaj.art-1657db8ecd084bcb9dd6cb72721293da2023-11-24T05:45:55ZengMDPI AGMedicina1010-660X1648-91442022-10-015811150410.3390/medicina58111504Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency DepartmentKyeong-Ryong Lee0Dae-Young Hong1Jin-Hui Paik2Hyun-Min Jung3Department of Emergency Medicine, Konkuk University School of Medicine, Seoul 05030, KoreaDepartment of Emergency Medicine, Konkuk University School of Medicine, Seoul 05030, KoreaDepartment of Emergency Medicine, Inha University School of Medicine, Incheon 22332, KoreaDepartment of Emergency Medicine, Inha University School of Medicine, Incheon 22332, Korea<i>Background and Objectives</i>: Presepsin (PSS) is an independent predictor for estimating disease severity and prognosis in septic patients. Few studies have reported the associations between plasma PSS and the severity and prognosis in patients with community-acquired pneumonia (CAP). We investigated whether a high plasma PSS level was associated with 30-day mortality in CAP patients. <i>Materials and Methods</i>: This retrospective single-center study was conducted in an emergency department. The PSS level was measured in 211 adult CAP patients admitted to the hospital and followed for up to 30 days. We recorded the pneumonia severity index (PSI) and the CURB-65 score. The primary outcome was death from any cause within 30 days. <i>Results</i>: The plasma PSS levels were significantly elevated in the high-risk group (PSI > 130) compared with the low- (PSI < 91) or moderate-risk groups (PSI 91–130). Forty-four patients (20.9%) died within 30 days of admission. Non-survivors had significantly higher plasma PSS levels than survivors among CAP patients: 1083 (697–1736) pg/mL vs. 385 (245–554) pg/mL (<i>p</i> < 0.001). The area under the curve (AUC) to predict 30-day mortality was highest for PSS (0.867), followed by procalcitonin (0.728) and lactate (0.616). The cutoff level of plasma PSS for 30-day mortality was >754 pg/mL. The combination of PSI and plasma PSS level improved the predictive ability for 30-day mortality (AUC = 0.892). Cox regression analysis showed that higher PSS levels (>754 pg/mL) and higher PSI (>126) were associated with 30-day mortality in CAP patients (hazard ratios of 19.472 and 6.375, respectively). <i>Conclusion</i>: Elevated plasma PSS is associated with severity and 30-day mortality in hospitalized CAP patients. Combining plasma PSS level and PSI could significantly improve the predictive ability of PSS for 30-day mortality.https://www.mdpi.com/1648-9144/58/11/1504presepsinpneumoniabiomarkersdisease severitymortality |
| spellingShingle | Kyeong-Ryong Lee Dae-Young Hong Jin-Hui Paik Hyun-Min Jung Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department Medicina presepsin pneumonia biomarkers disease severity mortality |
| title | Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department |
| title_full | Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department |
| title_fullStr | Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department |
| title_full_unstemmed | Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department |
| title_short | Prognostic Value of Plasma Presepsin and Pneumonia Severity Index in Patients with Community-Acquired Pneumonia in the Emergency Department |
| title_sort | prognostic value of plasma presepsin and pneumonia severity index in patients with community acquired pneumonia in the emergency department |
| topic | presepsin pneumonia biomarkers disease severity mortality |
| url | https://www.mdpi.com/1648-9144/58/11/1504 |
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