[Multivariate Analyses on Clinical Utility and Sources of Variation of Serum Presepsin as a Diagnostic Marker for Sepsis].

OBJECTIVE: Clinical utility of a new marker for sepsis, presepsin, was evaluated by use of a case-control study design.

METHOD: Enrolled in the study were seventy-one consecutive cases for whom blood culture was ordered in suspicion of sepsis. After the culture, 36 subjects were diagnosed as having a state of sepsis (S group) and 35 were denied of sepsis (NS group). The serum level of presepsin was measured together with basic chemistry tests and complete blood counts at the time of diagnosis.

RESULTS: Median serum presepsin for the two groups were 1,602 and 586 pg/mL, respectively. The difference was significant by Mann-Whitney test (P < 0.001). Logistic regression analysis was performed to evaluate contribution of presepsin in diagnosing sepsis in comparison with other markers for septic state. The result showed that presepsin was most powerful in predicting sepsis together with monocyte count percent (Mo). The diagnostic accuracy by use of logistic equation including both presepsin and Mo was 0.86 in terms of area under ROC curve (AUC), whereas AUC by use of an equation with presepsin alone was 0.80. Additionally, multiple regression analysis was performed to evaluate sources of variation of presepsin. It revealed that serum albumin and eGFR were negatively associated with serum level of presepsin.

CONCLUSION: It is recommended to look at Mo together with presepsin in the diagnosis of sepsis. Serum level of presepsin is raised in the presence of renal dysfunction and/or hypoalbuminemia.