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Critical Care
Published in: Critical Care 5/2013

Open Access 01-10-2013 | Research

Diagnostic value and prognostic evaluation of Presepsin for sepsis in an emergency department

Authors: Bo Liu, Yun-Xia Chen, Qin Yin, Yun-Zhou Zhao, Chun-Sheng Li

Published in: Critical Care | Issue 5/2013

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Abstract

Introduction

Presepsin levels are known to be increased in sepsis. The aim of this study was to evaluate the early diagnostic and prognostic value of Presepsin compared with procalcitonin (PCT), Mortality in Emergency Department Sepsis (MEDS) score and Acute Physiology and Chronic Health Evaluation II (APACHE II) score in septic patients in an emergency department (ED) and to investigate Presepsin as a new biomarker of sepsis.

Methods

This study enrolled 859 consecutive patients with at least two diagnostic criteria for systemic inflammatory response syndrome (SIRS) who were admitted to Beijing Chao-yang Hospital ED from December 2011 to October 2012, and 100 age-matched healthy controls. Patients were stratified into four groups: SIRS, sepsis, severe sepsis, and septic shock. Plasma Presepsin and serum PCT were measured, and MEDS score and APACHE II score were calculated at enrollment. Comparisons were analyzed using the Kruskal-Wallis and Mann–Whitney U tests.

Results

On admission, the median levels of plasma Presepsin increased with sepsis severity. The areas under the receiver operating characteristic (AUC) curves of Presepsin were greater than those of PCT in diagnosing sepsis, and predicting severe sepsis and septic shock. The AUC of Presepsin for predicting 28-day mortality in septic patients was slightly lower than that of PCT, MEDS score and APACHE II score. The AUC of a combination of Presepsin and MEDS score or APACHE II score was significantly higher than that of MEDS score or APACHE II score alone in predicting severe sepsis, and was markedly higher than that of Presepsin alone in predicting septic shock and 28-day mortality in septic patients, respectively. Plasma Presepsin levels in septic patients were significantly higher in non-survivors than in survivors at 28 days’ follow-up. Presepsin, MEDS score and APACHE II score were found to be independent predictors of severe sepsis, septic shock and 28-day mortality in septic patients. The levels of plasma Presepsin were positively correlated with PCT, MEDS score and APACHE II score in every septic group.

Conclusion

Presepsin is a valuable biomarker for early diagnosis of sepsis, risk stratification, and evaluation of prognosis in septic patients in the ED.
Appendix
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Literature
1.
Protti A, Singer M: Bench-to-bedside review: potential strategies to protect or reverse mitochondrial dysfunction in sepsis-induced organ failure. Crit Care 2006, 10: 228. 10.1186/cc5014PubMedCentralCrossRefPubMed
2.
Wright SD, Ramos RA, Tobias PS, Ulevitch RJ, Mathison JC: CD14, a receptor for complexes of lipopolysaccharide (LPS) and LPS binding protein. Science 1990, 249: 1431-1433. 10.1126/science.1698311CrossRefPubMed
3.
Shirakawa K, Naitou K, Hirose J, Takahashi T, Furusako S: Presepsisn (sCD14-ST): development and evaluation of one-step ELISA with a new standard that is similar to the form of presepsin in septic patients. Clin Chem Lab Med 2011, 49: 937-939.CrossRefPubMed
4.
Yaegashi Y, Shirakawa K, Sato N, Suzuki Y, Kojika M, Imai S, Takahashi G, Miyata M, Furusako S, Endo S: Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis. J Infect Chemother 2005, 11: 234-238. 10.1007/s10156-005-0400-4CrossRefPubMed
5.
Shozushima T, Takahashi G, Matsumoto N, Kojika M, Okamura Y, Endo S: Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother 2011, 17: 764-769. 10.1007/s10156-011-0254-xCrossRefPubMed
6.
Okamura Y, Yokoi H: Development of a point-of-care assay system for measurement of presepsin (sCD14-ST). Clin Chim Acta 2011, 412: 2157-2161. 10.1016/j.cca.2011.07.024CrossRefPubMed
7.
Endo S, Yaegashi Y, Sato N, Suzuki Y, Ogawa M, Kojika M: Comparative study of soluble CD14 and soluble CD14-subtype in sepsis. Med Postgrad 2006, 44: 381-385.
8.
Miyata M, Sato N, Takahashi G, Takahashi M, Endo S: The utility of the soluble CD-14-subtype for diagnosis of sepsis, the examination of the simple diagnostic kit. J Iwate Med Assoc 2007, 59: 325-331.
9.
Endo S, Suzuki Y, Takahashi G, Shozushima T, Ishikura H, Murai A, Nishida T, Irie Y, Miura M, Iguchi H, Fukui Y, Tanaka K, Nojima T, Okamura Y: Usefulness of presepsin in the diagnosis of sepsis in a multicenter prospective study. J Infect Chemother 2012, 18: 891-897. 10.1007/s10156-012-0435-2CrossRefPubMed
10.
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G, International Sepsis Definitions Conference: SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Intensive Care Med 2001,2003(29):530-538.
11.
Calandra T, Cohen J: The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005, 33: 1538-1548. 10.1097/01.CCM.0000168253.91200.83CrossRefPubMed
12.
Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ: Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004, 39: 1267-1284. 10.1086/425368CrossRefPubMed
13.
Kurihara T, Yanagida A, Yokoi H, Koyata A, Matsuya T, Ogawa J, Okamura Y, Miyamoto D: Evaluation of cardiac assays on a benchtop chemiluminescent enzyme immunoassay analyzer, PATHFAST. Anal Biochem 2008, 375: 144-146. 10.1016/j.ab.2007.12.030CrossRefPubMed
14.
Shapiro NI, Wolfe RE, Moore RB, Smith E, Burdick E, Bates DW: Mortality in emergency department sepsis (MEDS) scores: a prospectively derived and validated clinical prediction rule. Crit Care Med 2003, 31: 670-675. 10.1097/01.CCM.0000054867.01688.D1CrossRefPubMed
15.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II:a severity of disease classification system. Crit Care Med 1985, 13: 818-829. 10.1097/00003246-198510000-00009CrossRefPubMed
16.
Martin GS, Mannino DM, Eaton S, Moss M: The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003, 348: 1546-1554. 10.1056/NEJMoa022139CrossRefPubMed
17.
Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome and associated costs of care. Crit Care Med 2001, 29: 1303-1310. 10.1097/00003246-200107000-00002CrossRefPubMed
18.
Mussap M, Noto A, Fravega M, Fanos V: Soluble CD14 subtype presepsin (sCD14-ST) and lipopolysaccharide binding protein (LBP) in neonatal sepsis: new clinical and analytical perspectives for two old biomarkers. J Matern Fetal Neonatal Med 2011, 24: 12-14.CrossRefPubMed
19.
Naitoh K, Shirakawa K, Hirose J, Nakamura M, Takeuchi T, Hosaka Y, Furusako S: The new sepsis marker, sCD14-ST (PRESEPSIN): induction mechanism in the rabbit sepsis models. Crit Care 2010, 14: P19.
20.
Schuetz P, Christ-Crain M, Mueller B: Procalcitonin and other biomarkers for the assessment of disease severity and guidance of treatment in bacterial infections. Adv Sepsis 2008, 6: 82-89.
21.
Naeini AE, Montazerolghaem S: Procalcitonin marker for sepsis diagnosis. Evaluating a rapid immuno-chromatografi c test. Saudi Med J 2006, 27: 422-424.PubMed
22.
Oshita H, Sakurai J, Kamitsuna M: Semi-quantitative procalcitonin test for the diagnosis of bacterial infection: clinical use and experience in Japan. J Microbiol Immunol Infect 2010, 43: 222-227. 10.1016/S1684-1182(10)60035-7CrossRefPubMed
23.
Schuetz P, Chiappa V, Briel M, Greenwald JL: Procalcitonin algorithms for antibiotic therapy decisions. A systematic review of randomized controlled trials and recommendations for clinical algorithms. Arch Intern Med 2011, 171: 1322-1331. 10.1001/archinternmed.2011.318CrossRefPubMed
24.
Schuetz P, Briel M, Christ-Crain M, Stolz D, Bouadma L, Wolff M, Luyt CE, Chastre J, Tubach F, Kristoffersen KB, Wei L, Burkhardt O, Welte T, Schroeder S, Nobre V, Tamm M, Bhatnagar N, Bucher HC, Mueller B: Procalcitonin to guide initiation and duration of antibiotic treatment in acute respiratory infections: an individual patient data meta-analysis. Clin Infect Dis 2012, 55: 651-662. 10.1093/cid/cis464PubMedCentralCrossRefPubMed
25.
Christ-Crain M, Müller B: Procalcitonin in bacterial infections – hype, hope, more or less? Swiss Med Wkly 2005, 135: 451-456.PubMed
26.
Venkataraman R, Kellum JA: Sepsis: update in the management. Adv Chronic Kidney Dis 2013, 20: 6-13. 10.1053/j.ackd.2012.10.013CrossRefPubMed
27.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R, Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup: Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med 2013, 41: 580-637. 10.1097/CCM.0b013e31827e83afCrossRefPubMed
28.
Ruiz-Alvarez MJ, García-Valdecasas S, de Pablo R, Sanchez García M, Coca C, Groeneveld TW, Roos A, Daha MR, Arribas I: Diagnostic efficacy and prognostic value of serum procalcitonin concentration in patients with suspected sepsis. J Intensive Care Med 2009, 24: 63-71.CrossRefPubMed
Metadata
Title
Diagnostic value and prognostic evaluation of Presepsin for sepsis in an emergency department
Authors
Bo Liu
Yun-Xia Chen
Qin Yin
Yun-Zhou Zhao
Chun-Sheng Li
Publication date
01-10-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13070

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