Presepsin as a Potential Prognostic Marker for Sepsis According to Actual Practice Guidelines
| Autor: | Adriana Mihaela Ciocâlteu-Ionescu, Rodica Pădureanu, Andreea Doriana Stănculescu, Luminița Cristina Chiuțu, Vlad Pădureanu, Andrei Ioan Drocaș, Ioana Andreea Gheonea, Alice Nicoleta Dragoescu, Dan Nicolae Florescu, Costin Teodor Streba, Alex Emilian Stepan, Valeriu Șurlin, Octavian Dragoescu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Surviving Sepsis Campaign lcsh:Medicine Medicine (miscellaneous) 030204 cardiovascular system & hematology Article law.invention Sepsis sepsis 03 medical and health sciences 0302 clinical medicine law Internal medicine Medicine Prospective cohort study business.industry Septic shock lcsh:R Organ dysfunction Glasgow Coma Scale 030208 emergency & critical care medicine medicine.disease Intensive care unit presepsin septic shock SOFA score prognosis medicine.symptom business |
| Zdroj: | Journal of Personalized Medicine Volume 11 Issue 1 Journal of Personalized Medicine, Vol 11, Iss 2, p 2 (2021) |
| ISSN: | 2075-4426 |
| DOI: | 10.3390/jpm11010002 |
| Popis: | The 2016 Surviving Sepsis Campaign guidelines define sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection. This study had the objective of assessing the efficacy of presepsin in the prognosis of sepsis. This was a single-center prospective study, performed in Craiova Emergency Hospital, that included 114 patients admitted in the Intensive Care Unit (ICU) department between 2018 and 2019 fulfilling the sepsis criteria. Including criteria were: age &ge 18, sepsis diagnosed by the Sequential Organ Failure Assessment (SOFA) score of pulmonary, abdominal, urinary, surgical or unknown origin, as well as lactate levels &ge 2 mmol/l and need of vasopressors for mean arterial pressure (MAP) &ge 65 mmHg, despite adequate volume resuscitations for patients with septic shock. Patients younger than 18, pregnant, immunocompromised, or with terminal illnesses were excluded. Based on disease severity, patients were distributed into two study groups: sepsis&mdash 76 patients and septic shock&mdash 38 patients. As expected, SOFA score and most of its components (PaO2/FiO2, platelets, and Glasgow Coma Score (GCS)) were significantly modified for patients with septic shock compared to those in the sepsis group and for survivors versus non-survivors. Overall death rate was 34.2%, with a significantly higher value for patients with septic shock (55.3% vs. 23.7%, p = 0.035). Sepsis marker presepsin was significantly elevated in all patients (2047 ng/mL) and significantly increased for the septic shock patients (2538 ng/mL, p < 0.001) and non-survivors (3138 ng/mL, p < 0.001). A significant correlation was identified between the SOFA score and presepsin (r = 0.883, p < 0.001). The receiver operating characteristics (ROC)-Area Under Curve (AUC) analysis showed significant prognostic values for presepsin regarding both sepsis severity (AUC = 0.726, 95% confidence interval CI = 0.635&ndash 0.806) and mortality risk (AUC = 0.861, 95%CI = 0.784&ndash 0.919). In conclusion, under the revised definition of sepsis, presepsin could be a useful marker for prognosis of sepsis severity and mortality risk. Additional data are required to confirm the value of presepsin in sepsis prognosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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