Publication: Diagnostic and prognostic utility of presepsin for sepsis in very elderly patients in the emergency department
Issued Date
2020-11-01
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ISSN
18733492
00098981
00098981
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2-s2.0-85091228781
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinica Chimica Acta. Vol.510, (2020), 723-732
Suggested Citation
Onlak Ruangsomboon, Phantakarn Panjaikaew, Apichaya Monsomboon, Tipa Chakorn, Chairat Permpikul, Chok Limsuwat Diagnostic and prognostic utility of presepsin for sepsis in very elderly patients in the emergency department. Clinica Chimica Acta. Vol.510, (2020), 723-732. doi:10.1016/j.cca.2020.09.014 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/58941
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Title
Diagnostic and prognostic utility of presepsin for sepsis in very elderly patients in the emergency department
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Abstract
© 2020 Elsevier B.V. Background: Presepsin, a biomarker for sepsis diagnosis, has not been studied in very elderly population. The study aimed to evaluate the diagnostic and prognostic value of Presepsin in very elderly patients compared to point-of-care Procalcitonin (PCT), C-reactive protein (CRP), and early warning scores (EWSs). Methods: This study prospectively enrolled 250 patients aged at least 75 years old, presenting to the Emergency Department of Siriraj Hospital with suspected sepsis during September 2019 and January 2020. They were classified into three groups: non-sepsis, sepsis, and septic shock. Biomarkers and EWS values at admission were determined. PCT was analyzed with non-BRAHM method. Results: Presepsin had valuable diagnostic utility for sepsis (AUC 0.792), comparable to PCT (AUC 0.751, p = 0.22) and CRP (AUC 0.767, p = 0.47). It also showed similar prognostic accuracy (AUC 0.683) with PCT (AUC 0.691, p = 0.68) and CRP (AUC 0.688, p = 0.85). The combination of Presepsin, PCT, and an EWS yielded the highest diagnostic accuracy for sepsis and septic shock and highest prognostic accuracy for 30-day mortality. Conclusion: Presepsin is a valuable diagnostic and prognostic biomarker for sepsis in very elderly emergency patients. The combination of Presepsin, PCT, and an EWS was the best modality for early sepsis diagnosis and prognostication.