Diagnostic and prognostic utility of presepsin for sepsis in very elderly patients in the emergency department.
Mortality
Presepsin
Sepsis
Septic shock
Journal
Clinica chimica acta; international journal of clinical chemistry
ISSN: 1873-3492
Titre abrégé: Clin Chim Acta
Pays: Netherlands
ID NLM: 1302422
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
24
05
2020
revised:
03
09
2020
accepted:
03
09
2020
pubmed:
19
9
2020
medline:
22
6
2021
entrez:
18
9
2020
Statut:
ppublish
Résumé
Presepsin, a biomarker for sepsis diagnosis, has not been studied in very elderly population. The study aimed to evaluate the diagnostic and prognostic value of Presepsin in very elderly patients compared to point-of-care Procalcitonin (PCT), C-reactive protein (CRP), and early warning scores (EWSs). This study prospectively enrolled 250 patients aged at least 75 years old, presenting to the Emergency Department of Siriraj Hospital with suspected sepsis during September 2019 and January 2020. They were classified into three groups: non-sepsis, sepsis, and septic shock. Biomarkers and EWS values at admission were determined. PCT was analyzed with non-BRAHM method. Presepsin had valuable diagnostic utility for sepsis (AUC 0.792), comparable to PCT (AUC 0.751, p = 0.22) and CRP (AUC 0.767, p = 0.47). It also showed similar prognostic accuracy (AUC 0.683) with PCT (AUC 0.691, p = 0.68) and CRP (AUC 0.688, p = 0.85). The combination of Presepsin, PCT, and an EWS yielded the highest diagnostic accuracy for sepsis and septic shock and highest prognostic accuracy for 30-day mortality. Presepsin is a valuable diagnostic and prognostic biomarker for sepsis in very elderly emergency patients. The combination of Presepsin, PCT, and an EWS was the best modality for early sepsis diagnosis and prognostication.
Sections du résumé
BACKGROUND
BACKGROUND
Presepsin, a biomarker for sepsis diagnosis, has not been studied in very elderly population. The study aimed to evaluate the diagnostic and prognostic value of Presepsin in very elderly patients compared to point-of-care Procalcitonin (PCT), C-reactive protein (CRP), and early warning scores (EWSs).
METHODS
METHODS
This study prospectively enrolled 250 patients aged at least 75 years old, presenting to the Emergency Department of Siriraj Hospital with suspected sepsis during September 2019 and January 2020. They were classified into three groups: non-sepsis, sepsis, and septic shock. Biomarkers and EWS values at admission were determined. PCT was analyzed with non-BRAHM method.
RESULTS
RESULTS
Presepsin had valuable diagnostic utility for sepsis (AUC 0.792), comparable to PCT (AUC 0.751, p = 0.22) and CRP (AUC 0.767, p = 0.47). It also showed similar prognostic accuracy (AUC 0.683) with PCT (AUC 0.691, p = 0.68) and CRP (AUC 0.688, p = 0.85). The combination of Presepsin, PCT, and an EWS yielded the highest diagnostic accuracy for sepsis and septic shock and highest prognostic accuracy for 30-day mortality.
CONCLUSION
CONCLUSIONS
Presepsin is a valuable diagnostic and prognostic biomarker for sepsis in very elderly emergency patients. The combination of Presepsin, PCT, and an EWS was the best modality for early sepsis diagnosis and prognostication.
Identifiants
pubmed: 32946797
pii: S0009-8981(20)30446-0
doi: 10.1016/j.cca.2020.09.014
pii:
doi:
Substances chimiques
Biomarkers
0
Lipopolysaccharide Receptors
0
Peptide Fragments
0
presepsin protein, human
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
723-732Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.