Comparison of Presepsin (CD14), Procalcitonin (PCT) and C- reactive protein (CRP) at different SOFA and APACHE II scores in sepsis patients

Alia Hassan Abd-Elfattah; Mohamed Mohamed Youssef Khaled; Akram Abdelbary Ahmed; Momen Yahia; Ahmed Mohamed El-bakry Mohamed Kotrob

doi:10.53730/ijhs.v6nS3.6637

Authors

Alia Hassan Abd-Elfattah Critical Care Medicine Department, Faculty of medicine, Cairo University, Egypt
Mohamed Mohamed Youssef Khaled Critical Care Medicine Department, Faculty of medicine, Cairo University, Egypt
Akram Abdelbary Ahmed Critical Care Medicine Department, Faculty of medicine, Cairo University, Egypt
Momen Yahia Critical Care Medicine Department, Faculty of medicine, Cairo University, Egypt
Ahmed Mohamed El-bakry Mohamed Kotrob Critical care specialist at Maady Armed Forces Compound Hospital, Egypt

Keywords:

sepsis, prognosis, outcome prediction, presepsin, CRP, procalcitonin, apache II scores

Abstract

Sepsis remains a major challenge in clinical practice with considerable morbidity and mortality despite modern treatments. Clinicians need good diagnostic and prognostic markers to identify infected patients who would rapidly benefit from prompt, empirical antibiotic therapy and other supportive treatment. to comparison of Presepsin (CD14), Procalcitonin (PCT) and C- reactive protein (CRP) at different SOFA and APACHE II scores in sepsis patients. A prospective cohort observational study was conducted in Critical Care Medicine Department, Faculty of medicine, Cairo University, Egypt recruiting admitted adult critically ill patients diagnosed. All subjects were recruited during the period from December 2013 to November 2015. All subjects were subjected to complete history taking, clinical examination, Complete blood count, Kidney and Liver function, Coagulation profiles, blood, urine, and sputum cultures ± wound or drain culture, presepsin, PCT and CRP plasma concentrations. Mean age of our study group was 49.8±16.05 years and mean APACHE II score 14±4.4 with mean length of ICU stay was 13.6±7.06 days.There was significantly higher frequency of DM and HTN in Non- survivors group than Survivors.SOFA score was significantly higher at all assessments in Non- survivors as compared to survivors on admission and at day 1, 3,7 and 15.

Downloads

Download data is not yet available.

References

Torio CM, Andrews RM. National inpatient hospital costs: the most expensive conditions by payer, 2011. Statistical Brief #160. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. August 2013. http://www.ncbi.nlm.nih.gov/books /NBK169005/. Accessed October 31, 2015.

Iwashyna TJ, Cooke CR, Wunsch H, Kahn JM. Population burden of long-term survivorship after severe sepsis in older Americans.J Am Geriatr Soc. 2012;60(6):1070-1077.

Gaieski DF, Edwards JM, Kallan MJ, Carr BG. Benchmarking the incidence and mortality of severe sepsis in the United States. Crit Care Med. 2013;41(5):1167-1174.

Dellinger RP, Levy MM, Rhodes A, et al; Surviving Sepsis Campaign Guidelines Committee Including the Pediatric Subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580-637.

Farag NA, Taema KM, Abdel-Latiff E, Hamed G. Differentiating sepsis from noninfective systemic inflammatory response syndrome: comparison between Creactive protein and leptin. Egypt J Critic Care Med 2013;1(3):111–8.

Wright SD, Ramos RA, Tobias PS, Ulevitch RJ, Mathison JC. CD14, a receptor for complexes of lipopolysaccharide (LPS) and LPS binding protein. Science 1990;249(4975):1431–3.

Liu B, Chen YX, Yin Q, Zhao YZ, Li CS. Diagnostic value and prognostic evaluation of presepsin for sepsis in an emergency department. Crit Care 2013;17(5): R244

Pugin J, Heumann ID, Tomasz A, Kravchenko VV, Akamatsu Y, Nishijima M, et al. CD14 is a pattern recognition receptor. Immunity 1994;1(6):509–16.

Giavarina D, Carta M. Determination of reference interval for presepsin, an early marker for sepsis. Biochem Med (Zagreb) 2015;25(1):64–8.

Masson S, Caironi P, Spanuth E, Thomae R, Panigada M, Sangiorgi G, et al. Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the albumin italian outcome sepsis trial. Crit Care 2014;18(1):R6.

Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ ESICM/ACCP/ATS/SIS international sepsis definitions conference. Intensive Care Med 2003;29(4):530–8.

Wang JF, Yu ML, Yu G, et al. (2010): Serum miR-146a and miR-223 as potential new biomarkers for sepsis.". Biochem Biophys Res Commun; 394 (1): 184–8.

Angus DC, Linde-Zwirble WT, Lidicker J, et al. (2001): Epidemiology of severe sepsis in the united states: analysis of incidence, outcome, and associated costs of care. Crit Care Med; 29:1303-1310.

Martin GS, Mannino DM, Eaton S, et al. (2003): The epidemiology of sepsis in the united states from 1979 through 2000; N Engl J Med; 348: 1546-1554.

Ulla M, Pizzolato E, Lucchiari M, Loiacono M, Soardo F, Forno D, et al. Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study. Crit Care 2013;17(4):R168.

Masson S, Caironi P, Fanizza C, Thomae R, Bernasconi R, Noto A, et al. Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: data from the multicenter, randomized ALBIOS trial. Intensive Care Med 2015;41(1):12–20.

Shozushima T, Takahashi G, Matsumoto N, Kojika M, Okamura Y, Endo S. Usefulness of presepsin (sCD14-ST) measurements as a marker for the diagnosis and severity of sepsis that satisfied diagnostic criteria of systemic inflammatory response syndrome. J Infect Chemother 2011;17(6):764–9.

Kojika M, Takahashi G, Matsumoto N, Kikkawa T, Hoshikawa K, Shioya N, et al. Serum levels of soluble CD14 subtype reflect the APACHE II and SOFA scores. Med Postgraduates 2010;48(1):46–50.

Spanuth E, Ebelt H, Ivandic BT, Werdan K. Diagnostic and prognostic value of presepsin (soluble CD14 subtype) in emergency patients with early sepsis using the new assay PATHFAST Presepsin. In: Renz H, Tauber R, editors Advances in clinical chemistry and laboratory medicine. Berlin: De Gruyter. p.129–33

Yousef AA, Amr YM, Suliman GA. The diagnostic value of serum leptin monitoring and its correlation with tumor necrosis factor-alpha in critically ill patients: a prospective observational study. Crit Care 2010;14(2):R33

Singh R, Kumar N, Bhattacharya A, Vajifdar H. Preoperative predictors of mortality in adult patients with perforation peritonitis. Indian J Crit Care Med 2011;15(3):157–63

Labelle A, Juang P, Reichley R, Micek S, Hoffmann J, Hoban A, et al. The determinants of hospital mortality among patients with septic shock receiving appropriate initial antibiotic treatment. Crit Care Med 2012;40(7):2016–21.

Cesur S, S_engȕl A, Kurtoǧlu Y, Kalpakçi Y, Özel SA, Bilgetürk A, et al. Prognostic value of cytokines (TNF-a, IL-10, leptin) and C-reactive protein serum levels in adult patients with nosocomial sepsis. J Microbiol Infect Dis 2011;1(3):101–9.

Barie PS, Hydo LJ, Fischer E. Utility of illness severity scoring for prediction of prolonged surgical critical care. J Trauma 1996;40(4):513–8. discussion 8-9.

Siddiqui S, Ahmed S, Manasia R. Apache II score as a predictor of Length of stay and outcome in our ICUs. JPMA 2005;55(6):253.

Engel JM, Junger A, Zimmer M, Hartmann B, Benson M, Rohrig R, et al. Correlation of a computerized SOFA score and derived measures with length of stay at an operative ICU. Anasthesiol Intensivmed Notfallmed Schmerzther 2003;38(6):397–402.

Ferreira FL, Bota DP, Bross A, Melot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA 2001;286(14):1754–8.

Moreno R, Vincent JL, Matos R, Mendonca A, Cantraine F, Thijs L, et al. The useof maximum SOFA score to quantify organ dysfunction/failure in intensivecare. Results of a prospective, multicentre study. Working Group on Sepsisrelated Problems of the ESICM. Intensive Care Med 1999;25(7):686–96.

Lobo SM, Lobo FR, Bota DP, Lopes-Ferreira F, Soliman HM, Melot C, et al. Creactive protein levels correlate with mortality and organ failure in critically ill patients. Chest 2003;123(6):2043–9.