Abstract
The present study aimed to investigate the role of plasma presepsin in the early detection of septic shock and in determining the prognosis and mortality of patients with sepsis. The study was conducted in the emergency department between 1 January 2017 and 1 July 2017. A total of 106 patients 18 years of age or older who were diagnosed with sepsis according to the quick sequential organ failure assessment (qSOFA) criteria were included in this prospective study. The patients' symptoms, vital signs, additional diseases, demographic attributes, laboratory results, Mortality in Emergency Department Sepsis (MEDS) scores, imaging findings and treatments were recorded. Moreover, the patients' blood samples were collected to measure plasma presepsin, procalcitonin and CRP levels. In total, 55.7% of the patients were female. The median age of the patients was 78 (24-103) years, and their 30-day mortality rate was 67%. The presepsin level was significantly higher in the sepsis group than in the healthy control group (p < 0.001). The presepsin levels did not differ significantly between the sepsis and septic shock groups (p = 0.12). Similarly, the procalcitonin levels did not differ significantly between the sepsis and septic shock groups (p > 0.05). There was no significant difference in the presepsin, procalcitonin and CRP levels between survivor and non-survivor patients (p = 0.74). The plasma presepsin level was found to be ineffective in determining the incidence of septic shock and mortality in patients with sepsis in the emergency department.
Highlights
The present study aimed to investigate the role of the plasma presepsin level in the early detection of septic shock and in determining the prognosis and mortality of patients with sepsis
We wanted to compare the plasma presepsin level with plasma procalcitonin and C-reactive protein levels. This prospective study included patients 18 years of age or older who were diagnosed with sepsis and septic shock at the Emergency Medicine Department between 1 January 2017 and 1 July 2017 and whose treatment was started or followed in the intensive care unit
Sepsis is associated with a high mortality rate, and as it progresses towards septic shock, the mortality rate increases
Summary
The present study aimed to investigate the role of plasma presepsin in the early detection of septic shock and in determining the prognosis and mortality of patients with sepsis. The presepsin levels did not differ significantly between the sepsis and septic shock groups (p = 0.12). Conclusions: The plasma presepsin level was found to be ineffective in determining the incidence of septic shock and mortality in patients with sepsis in the emergency department. A specific diagnosis of bacteraemia is made by culturing the causative agent using blood and tissue fluid samples. Antimicrobial treatment is generally initiated on the basis of the clinical findings and on detecting a high level of inflammatory markers, such as leukocytes, C-reactive protein (CRP) and procalcitonin (PCT), in the peripheral venous blood [4]. Neither clinical findings nor inflammatory markers are sensitive or specific enough for the diagnosis of sepsis [4]
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