Aliu-Bejta Ajete, Kurshumliu Mentor, Namani Sadie, Dreshaj Shemsedin, Baršić Bruno
University Clinic of Infectious Diseases, Alexander Fleming, Pristina, 10000, Kosovo.
University of Pristina "Hasan Prishtina", Faculty of Medicine, Lagja e spitalit, p.n, Pristina, 10000, Kosovo.
J Clin Transl Sci. 2023 May 3;7(1):e121. doi: 10.1017/cts.2023.538. eCollection 2023.
Early diagnosis of sepsis is essential for a favorable disease outcome. The aim of this study was to evaluate the association of initial and subsequent presepsin concentrations with sepsis outcomes.
One hundred sepsis patients were enrolled in the study from two different university centers. Four times during study, concentrations of presepsin, procalcitonin (PCT), and C-reactive protein (CRP) were measured, and Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score were calculated. Patients were grouped into survivors and nonsurvivors. A sandwich ELISA kit was used to measure presepsin concentrations. To test the changes in biomarkers concentrations and SOFA score and APACHE II score during the disease course and to estimate the differences between outcome groups, generalized linear mixed effects model was used. Receiver operating characteristic curve analysis was performed to determine the prognostic value of presepsin concentrations.
Initial values of presepsin, SOFA score, and APACHE II score were significantly higher in nonsurvivors compared to survivors. Concentrations of PCT and CRP did not differ significantly between outcome groups. ROC curve analyses show a greater predictive ability of initial presepsin concentrations for predicting mortality compared to subsequent measurements of presepsin concentrations.
Presepsin has a good ability to predict mortality. Initial presepsin concentrations better reflects poor disease outcome compared to presepsin concentrations 24 and 72 hours after admission.
脓毒症的早期诊断对于良好的疾病转归至关重要。本研究的目的是评估初始和后续可溶性髓系细胞触发受体-1（presepsin）浓度与脓毒症预后的相关性。
从两个不同的大学中心招募了100例脓毒症患者。在研究期间测量4次presepsin、降钙素原（PCT）和C反应蛋白（CRP）的浓度，并计算序贯器官衰竭评估（SOFA）评分和急性生理与慢性健康状况评估（APACHE II）评分。将患者分为存活者和非存活者。使用夹心酶联免疫吸附测定（ELISA）试剂盒测量presepsin浓度。为了测试疾病过程中生物标志物浓度、SOFA评分和APACHE II评分的变化，并估计结局组之间的差异，使用了广义线性混合效应模型。进行受试者工作特征曲线分析以确定presepsin浓度的预后价值。
与存活者相比，非存活者的presepsin初始值、SOFA评分和APACHE II评分显著更高。结局组之间PCT和CRP的浓度没有显著差异。ROC曲线分析表明，与后续presepsin浓度测量相比，初始presepsin浓度对预测死亡率具有更强的预测能力。
Presepsin具有良好的预测死亡率的能力。与入院后24小时和72小时的presepsin浓度相比，初始presepsin浓度更能反映不良的疾病结局。
