Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study

作者：Marco Ulla, Elisa Pizzolato, Manuela Lucchiari, Maria Loiacono, Flavia Soardo, Daniela Forno, Fulvio Morello, Enrico Lupia, Corrado Moiraghi, Giulio Mengozzi, Stefania Battista · 发表于：Critical Care · 年份：2013 · DOI：10.1186/cc12847 · 被引用次数：268 · 研究领域：Sepsis Diagnosis and Treatment、Immune Response and Inflammation、Neonatal and Maternal Infections

INTRODUCTION: Sepsis, severe sepsis and septic shock are common conditions with high mortality. Their early diagnosis in the Emergency Department (ED) is one of the keys to improving survival. Procalcitonin (PCT) has been used as a biomarker in septic patients but has limited specificity and can be elevated in other scenarios of systemic inflammatory response syndrome (SIRS). Soluble CD14 (sCD14) or presepsin is the free fragment of a glycoprotein expressed on monocytes and macrophages. Preliminary reports suggest that levels of presepsin are significantly higher in septic patients than in healthy individuals. The aim of this study is to investigate the diagnostic and prognostic value of presepsin compared to PCT in people presenting at the ED with SIRS and suspected sepsis or septic shock. METHODS: This study was conducted in two major hospitals in Turin, Italy. One hundred six patients presenting to the EDs with suspected sepsis or septic shock were included, and another eighty-three patients affected by SIRS, but with no clinical evidence of infection, were recruited as controls. Blood samples were collected at first medical evaluation and for some patients after 24 and 72 h. The samples were analyzed using the PATHFAST Presepsin assay for sCD14, and commercial kits were used for other determinations (for example, PCT). Definitive diagnosis and survival rates were obtained afterward by analysis of digital medical records. RESULTS: Elevated concentrations of presepsin at pr...