الفهرس 
SEPSISOnly 14 pages are availabe for public view
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Abstract
This was a prospective analytical study conducted on 50 patients; to compare the presepsin and procalcitonin in early sepsis diagnosis.
The study will be conducted in military hospitals at Cairo, and Ain shams university hospitals, recruiting admitted critically ill patients who fulfilled the criteria for sepsis as defined by the society of critical care medicine (SCCM) and European Society Of Intensive Care Medicine (ESICM) which define sepsis as life- threating organ dysfunction due to a dysregulated host response to infection.
All patients included in the study will be candidates for: clinical assessment as Full History taking and physical examination, with acute physiology and chronic health evaluation II score (APACHE II score) assessed on admission and sequential organ failure assessment (SOFA) score to be assessed on admission, on days 2 and 4. Vital signs monitoring (blood pressure, temperature, respiratory rate, heart rate central venous pressure, urine output and random blood sugar every two hours.)
On admission to ICU all cases will perform pelvic abdominal ultrasound and echocardiography.
The following laboratory investigations will be done to all included patient: presepsin and procalcitonin at zero time, after 6 hours (1st measurement), after 12 hours (2nd measurement), after 18 hours (3rd measurement), after 24 hours (4th measurement), and at the 3rd day (5th measurement), along with serum lactate daily, Complete blood count (HB, platelet, differential leucocytes) daily,serum creatinine daily, serum urea daily, Serum sodium daily, Serum potassium daily. Total bilirubin daily, Aspartate aminotransferase (AST) daily, Alanine aminotransferase daily, INR daily. Serum albumin daily and culture and sensitivity.
Comparative study between the 2 groups revealed;
• Highly significant increase in baseline TLC and Presepsin, in positive “worse” group; compared to negative “improved” group (p < 0.05 respectively).
• Marked increase in TLC in positive “worse” group; compared to negative “improved” group; during the serial measurements.
• Marked increase in Presepsin in positive “worse” group; compared to negative “improved” group; during the serial measurements.
• Marked increase in Procalcitonin in positive “worse” group; compared to negative “improved” group; during the serial measurements
By using ROC-curve analysis,
• Early Presepsin level at a cutoff point (>379) predicted patients with negative cultures, with good (82%) accuracy, sensitivity= 100% and specificity= 80% (p < 0.01).
• Early Procalcitonin level showed non-significant predictive values in discrimination of patients with negative cultures from patients without (p > 0.05).
• Early Presepsin level at a cutoff point (>1620) predicted patient’s mortality, with fair (73%) accuracy, sensitivity= 73% and specificity= 87.5% (p < 0.05).
• Early Procalcitonin level showed non-significant predictive values in discrimination of patients with mortality (p > 0.05).
Conclusion: the present study suggests that presepsin and PCT are valuable biomarkers for early sepsis diagnosis, risk stratification and predicting short-term mortality. Furthermore, our findings demonstrate that presepsin has proven to be a promising candidate for more accurate and earlier prediction of abnormal host responsemore than procalcitonin, giving preliminary indications that presepsin has an unquestionable effectiveness in monitoring clinical responses to therapeutic interventions.