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Original Research

Open Access

Presepsin levels for discriminating sepsis and predicting mortality among organ failure patients stratified by hypercreatinemia

  • Hyunju Kim1
  • Juhyun Song1,*,
  • Sukyo Lee1
  • Dae Won Park2
  • Sejoong Ahn1
  • Jooyeong Kim1
  • Jonghak Park1
  • Han-jin Cho1
  • Sungwoo Moon1
  • Sung-Hyuk Choi3

1Department of Emergency Medicine, Korea University Ansan Hospital, 15355 Ansan-si, Republic of Korea

2Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, 15355 Ansan-si, Republic of Korea

3Department of Emergency Medicine, Korea University Guro Hospital, 08308 Seoul, Republic of Korea

DOI: 10.22514/sv.2023.044 Vol.19,Issue 4,July 2023 pp.109-118

Submitted: 04 May 2022 Accepted: 28 June 2022

Published: 08 July 2023

*Corresponding Author(s): Juhyun Song E-mail: songcap97@hotmail.com

Abstract

To evaluate the accuracy of presepsin levels in diagnosing sepsis and predicting mortality among organ failure patients with and without hypercreatinemia in the emergency department (ED). This retrospective study was conducted on patients with positive quick sequential organ failure assessment (qSOFA) score and increase in SOFA score of ≥2 points. Hypercreatinemia, indicated by a creatinine level of ≥1.2 mg/dL, was defined as points ≥1 on the renal component of the SOFA score. The patients were divided into group 1 (sepsis with hypercreatinemia), group 2 (sepsis without hypercreatinemia), group 3 (non-sepsis with hypercreatinemia), and group 4 (non-sepsis without hypercreatinemia), and their presepsin levels were compared. Receiver operating characteristic curve (ROC) analyses were performed to determine the accuracy of presepsin in diagnosing sepsis and predicting 30-day mortality. The optimal cutoff values were obtained to determine the presence of sepsis and predict the 30-day mortality. In all, 420 patients were eligible for this study. The presepsin levels in all pairwise comparisons between the groups were different (Group 1; 1311.5 (732.0–2179.5), Group 2; 566.5 (353.0–928.0), Group 3; 400.0 (291.0–579.0), Group 4; 231.0 (154.0–346.0)). Among patients with hypercreatinemia, the presepsin area under the ROC (AUROC) for diagnosing sepsis was 0.884 (optimal cutoff: 706 pg/mL). Among patients without hypercreatinemia, the presepsin AUROC for diagnosing sepsis was 0.854 (optimal cutoff: 352 pg/mL). The optimal cutoff values for predicting the patients’ 30-day mortality with and without hypercreatinemia were 1077 pg/mL and 393 pg/mL, respectively. Different cutoff values of presepsin based on creatinine levels could effectively diagnose sepsis in ED patients with organ failure. Further, presepsin was found to be associated with 30-day mortality in ED patients with organ failure, regardless of hypercreatinemia.


Keywords

Kidney; Short-term mortality; Procalcitonin; Organ dysfunction scores


Cite and Share

Hyunju Kim,Juhyun Song,Sukyo Lee,Dae Won Park,Sejoong Ahn,Jooyeong Kim,Jonghak Park,Han-jin Cho,Sungwoo Moon,Sung-Hyuk Choi. Presepsin levels for discriminating sepsis and predicting mortality among organ failure patients stratified by hypercreatinemia. Signa Vitae. 2023. 19(4);109-118.

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