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Medicina (Kaunas). 2019 Feb 2;55(2). pii: E36. doi: 10.3390/medicina55020036.

Clinical Value of Presepsin in Comparison to hsCRP as a Monitoring and Early Prognostic Marker for Sepsis in Critically Ill Patients.

Author information

1
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71111, Egypt. mam_elham75@yahoo.com.
2
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71111, Egypt. sharafabeer@yahoo.com.
3
Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut 71111, Egypt. asomar_12@yahoo.com.
4
Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut 71111, Egypt. Abdlatif@aun.edu.eg.
5
Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut 71111, Egypt. alaa.atya@med.au.edu.eg.

Abstract

Sepsis carries a poor prognosis for critically ill patients, even withintensive management. We aimed to determined early predictors of sepsis-related in-hospital mortality and to monitor levels of presepsin and high sensitivity C reactive protein (hsCRP) during admission relative to the applied treatment and the development of complications.An observational study was conducted on 68 intensive care unit (ICU) patients with sepsis. Blood samples from each patient were collected at admission (day 0) for measuring presepsin, hsCRP, biochemical examination, complete blood picture and microbiological culture and at the third day (day 3) for measuring presepsin and hsCRP. Predictors of sepsis-related in-hospital mortality were assessed using regression analysis. Predictive abilities of presepsin and hsCRP were compared using the area under a receiver operating characteristic curve. The Kaplan⁻Meier method was used to estimate the overall survival rate.Results showed that the sepsis-related in-hospital mortality was 64.6%. The day 0 presepsin and SOFA scores were associated with this mortality. Presepsin levels were significantly higher at days 0 and 3 in non-survivors vs. survivors (p = 0.03 and p < 0.001 respectively) and it decreased over the three days in survivors. Presepsin had a higher prognostic accuracy than hsCRP at all the evaluated times. Overall, in comparison with hsCRP, presepsin was an early predictor of sepsis-related in-hospital mortality in ICU patients. Changes in presepsin concentrations over time may be useful for sepsis monitoring, which in turn could be useful for stratifying high-risk patients on ICU admission that benefit from intensive treatment.

KEYWORDS:

hsCRP; in-hospital mortality; presepsin; sepsis

PMID:
30717340
PMCID:
PMC6409617
DOI:
10.3390/medicina55020036
[Indexed for MEDLINE]
Free PMC Article

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