Role of Presepsin for the Diagnosis of Sepsis and ICU Mortality: A Prospective Controlled Study

Background: 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. Method: 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. Results: 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 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 [p < 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. Conclusion: 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.