Pancreatic Stone Protein as an Early Predictor of Adverse Events in Patients with Infection Presenting to the Emergency Department: A Pilot Study

Background: Pancreatic stone protein (PSP) has recently emerged as a novel biomarker with diagnostic and prognostic potential in sepsis. The present study aimed to investigate its role as an early prognosticator in patients presenting to the Emergency Department (ED) with various types of infection. Methods: Point-of-care PSP was measured in 102 consecutive patients (59.8% male) with mean age of 62.7 (±23.4) years, presenting to the ED with suspected or confirmed infection. We examined the utility of PSP to predict adverse events including death, development of septic shock or need for repeated medical evaluation due to persistence or worsening of initial symptoms during a 10-day follow-up period. Results: Respiratory tract infections were the most common (50%) followed by urinary tract infections (17.6%), sepsis of unknown origin (4.9%) and other infections (27.5%). PSP exhibited intermediate performance in predicting short-term adverse outcomes with an AUC of 0.734 (p < 0.001). In contrast, other inflammatory biomarkers such as procalcitonin, C-reactive protein (CRP) and White Blood Cells (WBCs) did not predict adverse outcomes (procalcitonin: AUC 0.680, p = 0.059; CRP: AUC 0.593, p = 0.072; WBC: AUC 0.635, p = 0.074). Conclusions: PSP appears to be a promising biomarker reflecting the severity of infection. Point-of-care PSP evaluation may serve as an early predictor of adverse events in patients presenting with infection to the ED.