Key result
Presepsin matches procalcitonin for postoperative complications but better predicts short- and intermediate-term mortality.
Why the study?
The predictive value of presepsin and procalcitonin levels for adverse postoperative complications and mortality in cardiac surgery patients was evaluated.
Do presepsin and procalcitonin levels predict adverse postoperative complications and mortality in cardiac surgery patients?
Observational (n=122)
Do presepsin and procalcitonin levels predict adverse postoperative complications and mortality in cardiac surgery patients?
Effect estimate: AUC 0.760 for presepsin vs AUC 0.692 for procalcitonin (95% CI 0.673-0.833)
p-value: p=0.25
Presepsin and procalcitonin have comparable predictive value for adverse organ outcomes after cardiac surgery, but presepsin is a superior predictor of short- and medium-term mortality.
Higher presepsin and procalcitonin levels may flag elevated postoperative risk after cardiac surgery; leaves open their added prognostic utility pending prospective validation.
Backgound: This study was aimed at evaluating the presepsin and procalcitonin levels to predict adverse postoperative complications and mortality in cardiac surgery patients. METHODS: A total of 122 cardiac surgery patients were enrolled for the study. Presepsin and procalcitonin levels were measured 48 h after the procedure. The primary endpoints were adverse renal, respiratory, and cardiovascular outcomes and mortality. RESULTS: Presepsin and procalcitonin levels were significantly higher in patients with adverse renal and respiratory outcome (p < 0.001 and 0.0081). The presepsin levels were significantly higher in patients with adverse cardiovascular outcome (p = 0.023) and the procalcitonin values in patients with sepsis (p = 0.0013). Presepsin levels were significantly higher in patients who died during hospitalization (382 pg/mL, interquartile range [IQR] 243-717.5 vs. 1,848 pg/mL, IQR 998-5,451.5, p = 0.049). In addition, the predictive value for in-hospital, 30-days, and 6-months mortality was higher for presepsin, with a significant difference between the 2 biomarkers (p = 0.025, p = 0.035, p = 0.003; respectively). Presepsin and procalcitonin seem to have comparable predictive value for adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Although a positive trend was notable for presepsin and adverse renal outcome (area under the ROC [receiver operating characteristic] curves [AUC] of 0.760, 95% CI 0.673-0.833 versus procalcitonin: AUC 0.692; 95% CI 0.601-0.773): no statistically significant difference was evident between the AUC of the 2 biomarkers (p = 0.25). CONCLUSIONS: Presepsin and -procalcitonin seem to have comparable predictive value for -adverse renal, cardiovascular, and respiratory outcome in cardiac surgery patients. Also, presepsin possesses a better predictive value for in-hospital, 30-days, and 6-months mortality.
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Clementi et al. (2018) conducted an observational in cardiac surgery (n=122). Presepsin and procalcitonin levels was evaluated on Adverse renal, respiratory, and cardiovascular outcomes and mortality (AUC 0.760 for presepsin vs AUC 0.692 for procalcitonin, 95% CI 0.673-0.833, p=0.25). Presepsin and procalcitonin showed comparable predictive value for adverse postoperative outcomes, but presepsin was a significantly better predictor of in-hospital, 30-day, and 6-month mortality.
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