Diagnostic and prognostic value of presepsin vs. established biomarkers in critically ill patients with sepsis or systemic inflammatory response syndrome

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10374455" target="_blank" >RIV/00216208:11110/18:10374455 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064165:_____/18:10374455

Výsledek na webu

<a href="https://doi.org/10.1515/cclm-2017-0839" target="_blank" >https://doi.org/10.1515/cclm-2017-0839</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1515/cclm-2017-0839" target="_blank" >10.1515/cclm-2017-0839</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Diagnostic and prognostic value of presepsin vs. established biomarkers in critically ill patients with sepsis or systemic inflammatory response syndrome

Popis výsledku v původním jazyce

Background: Inflammatory biomarkers may aid to distinguish between systemic inflammatory response syndrome (SIRS) vs. sepsis. We tested the hypotheses that (1) presepsin, a novel biomarker, can distinguish between SIRS and sepsis, and (2) higher presepsin levels will be associated with increased severity of illness and (3) with 28-day mortality, outperforming traditional biomarkers. Methods: Procalcitonin (PCT), C-reactive protein (CRP), presepsin, and lactate were analyzed in 60 consecutive patients (sepsis and SIRS, n = 30 per group) on day 1 (D1) to D3 (onset sepsis, or after cardiac surgery). The systemic organ failure assessment (SOFA) score was determined daily. Results: There was no difference in mortality in sepsis vs. SIRS (12/30 vs. 8/30). Patients with sepsis had higher SOFA score vs. patients with SIRS (11 +/- 4 vs. 8 +/- 5; p = 0.023), higher presepsin (AUC = 0.674; p &lt; 0.021), PCT (AUC = 0.791; p &lt; 0.001), CRP (AUC = 0.903; p &lt; 0.0001), but not lactate (AUC = 0.506; p = 0.941). Unlike other biomarkers, presepsin did not correlate with SOFA on D1. All biomarkers were associated with mortality on D1: presepsin (AUC = 0.734; p = 0.0006; best cutoff = 1843 pg/mL), PCT (AUC = 0.844; p &lt; 0.0001), CRP (AUC = 0.701; p = 0.0048), and lactate (AUC = 0.778; p &lt; 0.0001). Multiple regression analyses showed independent associations of CRP with diagnosis of sepsis, and CRP and lactate with mortality. Increased neutrophils (p = 0.002) and decreased lymphocytes (p = 0.007) and monocytes (p = 0.046) were also associated with mortality. Conclusions: Presepsin did not outperform traditional sepsis biomarkers in diagnosing sepsis from SIRS and in prognostication of mortality in critically ill patients. Presepsin may have a limited adjunct value for both diagnosis and an early risk stratification, performing independently of clinical illness severity.

Název v anglickém jazyce

Diagnostic and prognostic value of presepsin vs. established biomarkers in critically ill patients with sepsis or systemic inflammatory response syndrome

Popis výsledku anglicky

Background: Inflammatory biomarkers may aid to distinguish between systemic inflammatory response syndrome (SIRS) vs. sepsis. We tested the hypotheses that (1) presepsin, a novel biomarker, can distinguish between SIRS and sepsis, and (2) higher presepsin levels will be associated with increased severity of illness and (3) with 28-day mortality, outperforming traditional biomarkers. Methods: Procalcitonin (PCT), C-reactive protein (CRP), presepsin, and lactate were analyzed in 60 consecutive patients (sepsis and SIRS, n = 30 per group) on day 1 (D1) to D3 (onset sepsis, or after cardiac surgery). The systemic organ failure assessment (SOFA) score was determined daily. Results: There was no difference in mortality in sepsis vs. SIRS (12/30 vs. 8/30). Patients with sepsis had higher SOFA score vs. patients with SIRS (11 +/- 4 vs. 8 +/- 5; p = 0.023), higher presepsin (AUC = 0.674; p &lt; 0.021), PCT (AUC = 0.791; p &lt; 0.001), CRP (AUC = 0.903; p &lt; 0.0001), but not lactate (AUC = 0.506; p = 0.941). Unlike other biomarkers, presepsin did not correlate with SOFA on D1. All biomarkers were associated with mortality on D1: presepsin (AUC = 0.734; p = 0.0006; best cutoff = 1843 pg/mL), PCT (AUC = 0.844; p &lt; 0.0001), CRP (AUC = 0.701; p = 0.0048), and lactate (AUC = 0.778; p &lt; 0.0001). Multiple regression analyses showed independent associations of CRP with diagnosis of sepsis, and CRP and lactate with mortality. Increased neutrophils (p = 0.002) and decreased lymphocytes (p = 0.007) and monocytes (p = 0.046) were also associated with mortality. Conclusions: Presepsin did not outperform traditional sepsis biomarkers in diagnosing sepsis from SIRS and in prognostication of mortality in critically ill patients. Presepsin may have a limited adjunct value for both diagnosis and an early risk stratification, performing independently of clinical illness severity.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

10608 - Biochemistry and molecular biology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Clinical Chemistry and Laboratory Medicine

ISSN

1434-6621

e-ISSN

—

Svazek periodika

56

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

DE - Spolková republika Německo

Počet stran výsledku

11

Strana od-do

658-668

Kód UT WoS článku

000426657400025

EID výsledku v databázi Scopus

2-s2.0-85037861311