Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions
Abstract Background We investigated the diagnostic and prognostic value of presepsin among patients with organ failure, including sepsis, in accordance with the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Methods This prospective observational study included 420...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-021-07012-8 |
| _version_ | 1818964003392585728 |
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| author | Sukyo Lee Juhyun Song Dae Won Park Hyeri Seok Sejoong Ahn Jooyeong Kim Jonghak Park Han-jin Cho Sungwoo Moon |
| author_facet | Sukyo Lee Juhyun Song Dae Won Park Hyeri Seok Sejoong Ahn Jooyeong Kim Jonghak Park Han-jin Cho Sungwoo Moon |
| author_sort | Sukyo Lee |
| collection | DOAJ |
| description | Abstract Background We investigated the diagnostic and prognostic value of presepsin among patients with organ failure, including sepsis, in accordance with the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Methods This prospective observational study included 420 patients divided into three groups: non-infectious organ failure (n = 142), sepsis (n = 141), and septic shock (n = 137). Optimal cut-off values of presepsin to discriminate between the three groups were evaluated using receiver operating characteristic curve analysis. We determined the optimal cut-off value of presepsin levels to predict mortality associated with sepsis and performed Kaplan–Meier survival curve analysis according to the cut-off value. Cox proportional hazards model was performed to determine the risk factors for 30-day mortality. Results Presepsin levels were significantly higher in sepsis than in non-infectious organ failure cases (p < 0.001) and significantly higher in patients with septic shock than in those with sepsis (p = 0.002). The optimal cut-off value of the presepsin level to discriminate between sepsis and non-infectious organ failure was 582 pg/mL (p < 0.001) and between sepsis and septic shock was 1285 pg/mL (p < 0.001). The optimal cut-off value of the presepsin level for predicting the 30-day mortality was 821 pg/mL (p = 0.005) for patients with sepsis. Patients with higher presepsin levels (≥ 821 pg/mL) had significantly higher mortality rates than those with lower presepsin levels (< 821 pg/mL) (log-rank test; p = 0.004). In the multivariate Cox proportional hazards model, presepsin could predict the 30-day mortality in sepsis cases (hazard ratio, 1.003; 95% confidence interval 1.001–1.005; p = 0.042). Conclusions Presepsin levels could effectively differentiate sepsis from non-infectious organ failure and could help clinicians identify patients with sepsis with poor prognosis. Presepsin was an independent risk factor for 30-day mortality among patients with sepsis and septic shock. |
| first_indexed | 2024-12-20T12:54:12Z |
| format | Article |
| id | doaj.art-c993f5371dc846db8e23de9d736a450d |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-20T12:54:12Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-c993f5371dc846db8e23de9d736a450d2022-12-21T19:40:06ZengBMCBMC Infectious Diseases1471-23342022-01-0122111210.1186/s12879-021-07012-8Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitionsSukyo Lee0Juhyun Song1Dae Won Park2Hyeri Seok3Sejoong Ahn4Jooyeong Kim5Jonghak Park6Han-jin Cho7Sungwoo Moon8Department of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDivision of Infectious Diseases, Department of Internal Medicine, Korea University Ansan HospitalDivision of Infectious Diseases, Department of Internal Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalDepartment of Emergency Medicine, Korea University Ansan HospitalAbstract Background We investigated the diagnostic and prognostic value of presepsin among patients with organ failure, including sepsis, in accordance with the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Methods This prospective observational study included 420 patients divided into three groups: non-infectious organ failure (n = 142), sepsis (n = 141), and septic shock (n = 137). Optimal cut-off values of presepsin to discriminate between the three groups were evaluated using receiver operating characteristic curve analysis. We determined the optimal cut-off value of presepsin levels to predict mortality associated with sepsis and performed Kaplan–Meier survival curve analysis according to the cut-off value. Cox proportional hazards model was performed to determine the risk factors for 30-day mortality. Results Presepsin levels were significantly higher in sepsis than in non-infectious organ failure cases (p < 0.001) and significantly higher in patients with septic shock than in those with sepsis (p = 0.002). The optimal cut-off value of the presepsin level to discriminate between sepsis and non-infectious organ failure was 582 pg/mL (p < 0.001) and between sepsis and septic shock was 1285 pg/mL (p < 0.001). The optimal cut-off value of the presepsin level for predicting the 30-day mortality was 821 pg/mL (p = 0.005) for patients with sepsis. Patients with higher presepsin levels (≥ 821 pg/mL) had significantly higher mortality rates than those with lower presepsin levels (< 821 pg/mL) (log-rank test; p = 0.004). In the multivariate Cox proportional hazards model, presepsin could predict the 30-day mortality in sepsis cases (hazard ratio, 1.003; 95% confidence interval 1.001–1.005; p = 0.042). Conclusions Presepsin levels could effectively differentiate sepsis from non-infectious organ failure and could help clinicians identify patients with sepsis with poor prognosis. Presepsin was an independent risk factor for 30-day mortality among patients with sepsis and septic shock.https://doi.org/10.1186/s12879-021-07012-8PresepsinProcalcitoninOrgan failureSepsisSeptic shockMortality |
| spellingShingle | Sukyo Lee Juhyun Song Dae Won Park Hyeri Seok Sejoong Ahn Jooyeong Kim Jonghak Park Han-jin Cho Sungwoo Moon Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions BMC Infectious Diseases Presepsin Procalcitonin Organ failure Sepsis Septic shock Mortality |
| title | Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions |
| title_full | Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions |
| title_fullStr | Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions |
| title_full_unstemmed | Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions |
| title_short | Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: a prospective observational study according to the Sepsis-3 definitions |
| title_sort | diagnostic and prognostic value of presepsin and procalcitonin in non infectious organ failure sepsis and septic shock a prospective observational study according to the sepsis 3 definitions |
| topic | Presepsin Procalcitonin Organ failure Sepsis Septic shock Mortality |
| url | https://doi.org/10.1186/s12879-021-07012-8 |
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