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Original Research

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Presepsin as a predictor of septic shock and mortality in patients with urinary tract infection according to the Sepsis-3 definitions

  • Gi Bi Yang1
  • Kyeong Ryong Lee2
  • Dae Young Hong2
  • Sang O Park2
  • Jong Won Kim2
  • Sin Young Kim1
  • Young Hwan Lee2,*,

1Department of Emergency Medicine, Konkuk University Medical Center, 05030 Seoul, Republic of Korea

2Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 05030 Seoul, Republic of Korea

DOI: 10.22514/sv.2024.018 Vol.20,Issue 2,February 2024 pp.70-77

Submitted: 26 July 2023 Accepted: 29 August 2023

Published: 08 February 2024

*Corresponding Author(s): Young Hwan Lee E-mail: 20220483@kuh.ac.kr

Abstract

The objective of this study was to investigate whether presepsin can serve as a useful biomarker for predicting septic shock and mortality rates in patients with urinary tract infections (UTI) as defined by the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). This single-center and prospective observational study was carried out between December 2019 and December 2022 and included 171 UTI patients divided into two groups: a non-septic shock group (n = 121) and a septic shock group (n = 50). The primary outcome of this study was the development of septic shock; the secondary outcome was 30-day hospital mortality. Receiver operating characteristic (ROC) curves and multivariate regression analyses were performed to investigate the predictive value of presepsin levels for septic shock and the Cox proportional hazards model was used to determine the risk factors for 30-day hospital mortality in UTI patients. Septic shock patients had significantly higher serum levels of presepsin when compared to the non-septic shock group (p < 0.001). In multivariate logistic regression analysis, presepsin demonstrated its independent role as a risk factor for septic shock (odds ratio (OR): 1.002; 95% confidence interval (CI): 1.001–1.002; p < 0.001). The multivariate Cox proportional hazards model indicated that presepsin represents a significant predictor of 30-day hospital mortality in septic shock patients (hazard ratio (HR): 1.0005; 95% CI: 1.0001–1.001; p < 0.05). The ROC curve for diagnosing septic shock had an area under the curve (AUC) of 0.739 with a cutoff value of 447 pg/mL for presepsin. For the prediction of 30-day hospital mortality in patients with UTI, an optimal presepsin cutoff of 709 pg/mL was determined; ROC curve analysis yielded an AUC of 0.744. When applying the Sepsis-3 criteria, presepsin levels represented a significant independent risk factor for septic shock and 30-day hospital mortality in UTI patients.


Keywords

Presepsin; Septic shock; Urinary tract infection; Emergency department


Cite and Share

Gi Bi Yang,Kyeong Ryong Lee,Dae Young Hong,Sang O Park,Jong Won Kim,Sin Young Kim,Young Hwan Lee. Presepsin as a predictor of septic shock and mortality in patients with urinary tract infection according to the Sepsis-3 definitions. Signa Vitae. 2024. 20(2);70-77.

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