Predictive value of Presepsin for septic patients developed with multiple organs dysfunction in emergency department / 中华急诊医学杂志

ABSTRACT

Objective The present study aimed to explore the value of plasma Presepsin levels for predicting the incidence of multiple organs dysfunction (MOD) in septic patients in an emergency department (ED).Methods A prospective observational study was performed in the ED of Beijing Chao～Yang Hospital from November 2013 to October 2014.A total of 680 septic patients were consecutively enrolled.The septic patients who developed MOD or non-MOD were recorded.Plasma Presepsin and serum procalcitonin (PCT) levels were detected,and sepsis-related organ failure assessment (SOFA) score were calculated upon ED arrival.Results Plasma Presepsin levels at ED admission were significantly higher in patients with MOD [1023.5 (728.3-1 860.0) pg/mL] than in those without MOD [334.0 (218.0-479.5) pg/mL],and were not different between different types of organ dysfunction.Median Presepsin levels in septic patients with different numbers of organ dysfunction were 235.0 (172.0-340.3) pg/mL in those with no organ dysfunction,403.5 (275.8-587.3) pg/mL in those with one organ dysfunction,844.5 (559.8-1 259.5) pg/mL in those with two organs dysfunction,and 1 412.5 (893.0-2 675.8)pg/mL in those with three or more than organs dysfunction,respectively,which was statistically significant between every two groups.Presepsin,PCT and SOFA score were all the independent predictors of MOD.The areas under ROC curve (AUCs) of Presepsin for predicting MOD were 0.914,significantly higher than that of PCT (0.756) and SOFA score (0.840),respectively.Conclusions Plasma Presepsin levels were not different between different types of organ dysfunction.Presepsin levels increased with increasing numbers of organ dysfunction in septic patients,and Presepsin was superior to PCT and SOFA score in predicting the incidence of MOD.In conclusion,Presepsin was a valuable biomarker in evaluating MOD in septic patients in ED.