Abdelshafey Eslam E, Nasa Prashant, Elgohary Ahmed E, Khalil Mohammad F, Rashwan Mohammad A, Ghezala Hassen B, Tayar Ashraf A
Department of Critical Care Medicine, Alexandria, Egypt.
Department of Intensive Care Unit, Security Forces Hospital, Dammam, Saudi Arabia.
Indian J Crit Care Med. 2021 Feb;25(2):153-157. doi: 10.5005/jp-journals-10071-23715.
This study aimed at evaluating the role of presepsin in early identification of sepsis and prediction of mortality in intensive care unit (ICU) patients in comparison to systemic inflammatory response syndrome (SIRS) and quick sequential organ failure assessment (qSOFA) score.
Forty patients were selected randomly after admission to adult ICU. Data from emergency room (ER) triaging, and initial laboratory results were gathered to calculate qSOFA score, SIRS criteria, and SOFA score. Presepsin measurement was performed within 6 hours from ER triaging.The patients were categorized into sepsis and nonsepsis groups depending on the clinical and microbiological criteria and SOFA score changes.
Twenty-six patients were diagnosed as septic with an average age of 68.04 ± 18.60 years, while 14 patients were nonseptic with an average age of 51.71 ± 24.88 years.Presepsin with a cutoff value >640 pg/mL (area under the curve [AUC] of 0.848 ( < 0.001}) had a significant diagnostic accuracy of identifying septic cases with sensitivity of 73.08% and specificity of 92.86% as compared to the nonsignificant SIRS (AUC, 0.670; sensitivity, 69.23%; and specificity, 57.14%) or qSOFA (AUC, 0.652; sensitivity, 38.46%; and specificity, 78.57%) criteria.Prespsin with a cutoff value >640 pg/mL also significantly (AUC of 0.920 [ < 0.001]) predicted mortality with sensitivity of 100.0% and specificity of 66.67% compared to the nonsignificant SIRS (AUC, 0.540; sensitivity, 70.0%; and specificity, 43.33%) or qSOFA (AUC, 0.670; sensitivity, 60%; and specificity, 76.67%) criteria.
Early presepsin measurement in ICU patients is more accurate in the diagnosis of sepsis and prediction of mortality as compared to SIRS or qSOFA score.
Abdelshafey EE, Nasa P, Elgohary AE, Khalil MF, Rashwan MA, Ghezala HB, Role of Presepsin for the Diagnosis of Sepsis and ICU Mortality: A Prospective Controlled Study. Indian J Crit Care Med 2021;25(2):153-157.
本研究旨在评估与全身炎症反应综合征（SIRS）及快速序贯器官衰竭评估（qSOFA）评分相比，降钙素原在前瞻性识别脓毒症及预测重症监护病房（ICU）患者死亡率方面的作用。
40例成年ICU患者入院后随机选取。收集急诊室（ER）分诊数据及初始实验室检查结果以计算qSOFA评分、SIRS标准及SOFA评分。在ER分诊后6小时内进行降钙素原检测。根据临床和微生物学标准及SOFA评分变化将患者分为脓毒症组和非脓毒症组。
26例患者被诊断为脓毒症，平均年龄68.04±18.60岁，14例患者为非脓毒症，平均年龄51.71±24.88岁。与无显著意义的SIRS（曲线下面积[AUC]为0.670；敏感度为69.23%；特异度为57.14%）或qSOFA（AUC为0.652；敏感度为38.46%；特异度为78.57%）标准相比，降钙素原临界值>640 pg/mL（AUC为0.848[<0.001]）在识别脓毒症病例方面具有显著诊断准确性，敏感度为73.08%，特异度为92.86%。与无显著意义的SIRS（AUC为0.540；敏感度为70.0%；特异度为43.33%）或qSOFA（AUC为0.670；敏感度为60%；特异度为76.67%）标准相比，降钙素原临界值>640 pg/mL在预测死亡率方面也具有显著意义（AUC为0.920[<0.001]），敏感度为100.0%，特异度为66.67%。
与SIRS或qSOFA评分相比，ICU患者早期检测降钙素原在脓毒症诊断及死亡率预测方面更为准确。
Abdelshafey EE, Nasa P, Elgohary AE, Khalil MF, Rashwan MA, Ghezala HB, 降钙素原在脓毒症诊断及ICU死亡率预测中的作用：一项前瞻性对照研究。《印度重症监护医学杂志》2021；25(2):153 - 157。
