Background: Sepsis, which is a serious clinical condition and an effect of a system-wide inflammation, may result in multiorgan failure and mortality in patients. Currently, procalcitonin (PCT) and C-reactive protein (CRP) are utilized globally. In a recent emergence, the ability of presepsin to identify sepsis is explored, but its prognosis needs to be established.
Methods: The prospective study consisting of 58 cases with possible bacterial sepsis was studied. The analysis of several inflammatory markers including CRP, white blood cells, lactate, PCT, and presepsin was accomplished. Inpatients were followed up, and their data on mortality, the necessity of renal replacement therapy (RRT), and inotropic support were cumulated. The prospects of the biomarkers were analyzed by the use of logistic regression models. The p-value < 0.05 is considered to be statistically significant.
Results: About 1,000 pg/ml increase in presepsin was useful in predicting mortality by 40% and the need for RRT by 73% (p = 0.027). Diagnostic sensitivity, specificity, and area under the curve of presepsin for mortality and RRT were 0.786, 0.524, and 0.721 (p = 0.014) and 1.0, 0.565, and 0.946 (p < 0.0001), respectively. The role of PCT and lactate was insignificant as predicting and diagnostic markers.
Conclusion: Presepsin can be a prospective biomarker in the identification and progression of sepsis, prediction of mortality, and a decisive parameter about the necessity of RRT.
Key words: Sepsis, presepsin, procalcitonin, c-reactive protein, renal replacement therapy
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