Article Data

  • Views 3136
  • Dowloads 264

Original Research

Open Access

Role of Plasma Presepsin, Procalcitonin and C-reactive Protein Levels in Determining the Severity and Mortality of Community-Acquired Pneumonia in the Emergency Department

  • Izzettin Hur1
  • Seda Ozkan2
  • Ali Halici3
  • Kerim Abatay4
  • Eren Usul5
  • Esra Cetin6
  • Fevzi Nuri Aydin6

1Department of Emergency Medicine, Ministry of Health Pursaklar State Hospital, Ankara, Turkey

2Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey

3Department of Emergency Medicine, Ministry of Health Polatlı State Hospital, Ankara, Turkey

4Department of Emergency Medicine, Ministry of Health Muş State Hospital, Muş, Turkey

5Department of Emergency Medicine, Ministry of Health Dr. Nafiz Korez Sincan State Hospital, Ankara, Turkey

6Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training & Research Hospital, Ankara, Turkey

DOI: 10.22514/sv.2020.16.0034 Vol.16,Issue 2,October 2020 pp.61-68

Published: 28 October 2020

*Corresponding Author(s): Seda Ozkan E-mail: sedacil@gmail.com

Abstract

Objective: In this study, we aimed to explore the role of the plasma presepsin level in patients with community-acquired pneumonia during admission to the emergency department in assessing the diagnosis, severity, and prognosis of the disease. In addition, we wanted to investigate the relationship of presepsinin with procalcitonin, C-reactive protein and pneumonia severity scores. Methods: One hundred twenty-three patients over the age of 18 who presented with a diagnosis of pneumonia to the emergency department were included in the study. The vital signs, symptoms, examination findings, background information, laboratory results, and radiological imaging results of the patients were recorded. The 30-day mortality rates of the patients were determined. Results: A statistically significant difference was found between the presepsin levels of the patients diagnosed with pneumonia and those of healthy subjects (p < 0.05). The plasma presepsin levels of the patients who died (8.63 ± 6.46) were significantly higher than those of the patients who lived (5.82 ± 5.97) (p < 0.05). The plasma procalcitonin and C-reactive protein levels of the dead patients were significantly higher than those living (p < 0.05). A presepsin cut-off value of 3.3 ng/mL for 30-day mortality was established (AUROC, 0.65; specificity, 45%; sensitivity, 82%). Procalcitonin is the most successful biomarker in the determination of mortality (AUROC, 0.70). A significant correlation was available between presepsin and lactate, C-reactive protein and procalcitonin (p < 0.05). There was a significant correlation between the Pneumonia Severity Index values and presepsin levels (p < 0.001, r = 0.311). Conclusion: The plasma presepsin level can be utilized for diagnosing community-acquired pneumonia. Plasma presepsin, procalcitonin and C-reactive protein levels can be used to predict the severity and mortality of community-acquired pneumonia.

Keywords

Biomarkers, Pneumonia, Emergency department, Prognosis, Mortality

Cite and Share

Izzettin Hur,Seda Ozkan,Ali Halici,Kerim Abatay,Eren Usul,Esra Cetin,Fevzi Nuri Aydin. Role of Plasma Presepsin, Procalcitonin and C-reactive Protein Levels in Determining the Severity and Mortality of Community-Acquired Pneumonia in the Emergency Department. Signa Vitae. 2020. 16(2);61-68.

References

[1] Karakioulaki M, Stolz D. Biomarkers in Pneumonia-Beyond Procal-citonin. Int J Mol Sci. 2019;20:2004.

[2] Mandell LA, Wunderink RG, Anzueto A, et al. Infectious diseases society of America/American Thoracic Society consensus guidelines on the management of community acquired pneumonia in adults. Clin Infect Dis. 2007;44:27-72.

[3] Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997;336:243-250.

[4] Jones BE, Jones J, Bewick T, et al. CURB-65 Pneumonia Sever-ity Assessment Adapted for Electronic Decision Support. Chest. 2011;140:156-163.

[5] Aujesky D, Auble TE, Yealy DM, et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am J Med. 2005;118:384-392.

[6] Keramat F, Ghasemi Basir HR, Abdoli E, et al. Association of serum procalcitonin and C-reactive protein levels with CURB-65 criteria among patients with community-acquired pneumonia. Int J Gen Med. 2018;11:217-223.

[7] Halıcı A, Hür İ, Abatay K, et al. The role of presepsin in the diagnosis of chronic obstructive pulmonary disease acute exacerbation with pneumonia. Biomark Med. 2020;14:31-41.

[8] Shirakawa K, Naitou K, Hirose J, et al. Presepsin (sCD14-ST): development and evaluation of one-step ELISA with a new standard that is similar to the form of presepsin in septic patients. Clin Chem Lab Med. 2011;49:937-939.

[9] Mussap M, Puxeddu E, Burrai P, et al. Soluble CD14 subtype (sCD14-ST) presepsin in critically ill preterm newborns: preliminary reference ranges. J Matern Fetal Neonatal Med. 2012;25:51-53.

[10] Liu B, Chen YX, Yin Q,et al. Diagnostic value and prognostic evaluation of Presepsin for sepsis in an Emergency department. Crit Care. 2013;17:R244.

[11] Romualdo LG, Torrella PE, Gonzales MV, et al. Diagnostic accuracy of presepsin (soluble CD14 subtype) for prediction of bacteremia in patients with systemic inflammatory response syndrome in the Emergency Department. Clin Biochem. 2014;47:505-508.

[12] Ugajin M, Matsuura Y, Matsuura K, et al. Impact of initial plasma presepsin level for clinical outcome in hospitalized patients with pneumonia. J Thorac Dis. 2019;11:1387-1396.

[13] Wu J, Hu L, Zhang G, et al. Accuracy of Presepsin in Sepsis Diagnosis: A Systematic Review and Meta-Analysis. PLoS One. 2015;10:e0133057.

[14] Kweon OJ, Choi JH, Park SK, et al. Usefulness of presepsin (sCD14 subtype) measurements as a new marker for the diagnosis and prediction of disease severity of sepsis in the Korean population. J Crit Care. 2014;29:965-970.

[15] Nair GB, Niederman MS. Year in review 2013: critical care -respiratory infections. Crit Care. 2014;18:572.

[16] Klouche K, Cristol JP, Devin J, et al. Diagnostic and prognostic value of soluble CD14 subtype (Presepsin) for sepsis and community-acquired pneumonia in ICU patients. Ann Intensive Care. 2016;6:59..

[17] Metersky ML, Waterer G, Nsa W, et al. Predictors of In-Hospital vs Post discharge Mortality in Pneumonia. Chest. 2012;142:476-481.

[18] Zhou H, Guo S, Lan T, et al. Risk stratification and prediction value of procalcitonin and clinical severity scores for community-acquired pneumonia in ED. Am J Emerg Med. 2018;36:2155-2160.

[19] Behnes M, Bertsch T, Lepiorz D, et al. Diagnostic and prognostic utility of soluble CD 14 subtype (presepsin) for severe sepsis and septic shock during the first week of intensive care treatment. Crit Care. 2014;18:507.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.3 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top