To assess the diagnostic value of the reference levels of presepsin in the diagnosis of the systemic inflammatory response syndrome (SIRS) and sepsis in patients with nosocomial pneumonia (NP).
Material and methods
We recruited 100 patients (68 men, mean age of 62.1 ± 7.2 years) with NP who were distributed into the groups of patients without SIRS (n = 33), with 1 to 2 SIRS criteria (n = 29), sepsis (n = 38), severe sepsis (n = 8) and septic shock (n = 3). Presepsin levels were evaluated according to the technical documentation: <200 pg/ml – sepsis can be excluded; >300 pg/ml – systemic infection (sepsis) is possible; >500 pg/ml – moderate risk of systemic infection (severe sepsis); >1000 pg/ml – high risk of systemic infection (severe sepsis/septic shock). The diagnostic value of the presepsin levels was determined by ROC curves plots and measuring the area under the curve (AUC).
The AUC values in the first three groups were 30.1%, 44.4% and 64.5%, and indicated a low diagnostic value of presepsin concentration. AUC was high enough (75.2%) only in patients with severe sepsis. There was a statistically significant correlation between presepsin and creatinine levels (r = 0.439, p <0.001).
ROS analysis in patients with NP indicates a low diagnostic value of the reference presepsin levels in patients with the signs of SISR while it was higher in patients with severe sepsis. Presepsin levels in patients with NP should be interpreted cautiously taking into account the other clinical and laboratory data.
Nasocomial pneumonia, presepsin, markers of sepsis, infectious complications, diagnosis of sepsis.