Background: Infection is a challenge in intensive care units (ICUs), causing high mortality and morbidity. Early diagnosis and prediction is useful in improving management strategies of Adult patients. This study aimed at assessing the accuracy of presepsin for diagnosis of sepsis among adults.
Methods: This study was conducted on ninety-six patents within ICUs of Internal Medicine hospital Zagazig University from December 2019 and May 2020. All patients were assessed physically with quick SOFA score, laboratory investigations including serum presepsin level.
Results: Age of patients ranged from 19 to 60 years with median 56.5 years and male represented 54.2%. Positive blood culture was found in 75% of patients; out of them, 66.7%, 22.2% and 11.1% had infection, sepsis and septic shock respectively. About 57% and 24% had pneumonia and urinary tract infection respectively. Median C reactive protein (CRP) and procalcitonin were 62.5% and 1.7% respectively. Presepsin significantly positively correlated with procalcitonin and C reactive protein (p < 0.05). It significantly negatively correlated with platelet count (p < 0.05). There is significant association between serum presepsin and disease severity, with highest level in septic shock followed by sepsis (p < 0.05). The best cutoff of serum presepsin in diagnosis of infection was ≥1.95 mg/mL with sensitivity 80% and specificity 71% while at cutoff ≥2.4 mg/mL, it can predict sepsis, sensitivity 78.3% and specificity 69%. Presepsin cutoff ≥7.9 mg/mL can predict septic shock with sensitivity 90% and specificity 92%.
Conclusion: Presepsin is a promising marker for diagnosis of infection and sepsis with capability for differentiating between sepsis severity groups.