THE CLINICAL UTILITY OF PRESEPSIN (sCD14-ST) AS A DIAGNOSTIC AND PROGNOSTIC BIOMARKER IN SEPSIS: A COMPREHENSIVE REVIEW

Purpose: This review provides a comprehensive synthesis of current evidence regarding the diagnostic and prognostic utility of presepsin (soluble CD14 subtype, sCD14-ST) in sepsis by critically evaluating its role in early diagnosis, disease severity assessment, septic shock identification, and prediction of clinical outcomes. Methodology: A systematic review of scientific literature published from 2021 was performed using PubMed, Google Scholar, and other biomedical databases to evaluate the clinical utility of presepsin in patients with suspected sepsis. The analysis included systematic reviews, meta-analyses, prospective observational studies, and diagnostic trials involving adult and pediatric populations. Particular emphasis was placed on studies applying the Sepsis-3 criteria and evaluating diagnostic accuracy using sensitivity, specificity, diagnostic odds ratios, and area under the receiver operating characteristic curve (AUC). Findings: Presepsin demonstrates significant diagnostic value in the identification of sepsis, particularly in adult patients. Meta-analyses reported pooled sensitivities ranging from 0.782 to 0.86, specificities from 0.739 to 0.79, and AUC values of approximately 0.85–0.90. Presepsin also demonstrated the ability to differentiate sepsis from non-infectious organ failure and to identify patients at risk of septic shock. Its concentrations correlate with established indicators of disease severity, including SOFA and APACHE II scores and serum lactate levels. Compared with conventional biomarkers such as procalcitonin and C-reactive protein, presepsin demonstrated comparable or improved diagnostic performance in selected clinical settings. However, substantial heterogeneity in diagnostic thresholds, patient populations, and sepsis definitions limits the establishment of a universally applicable cutoff value. Conclusions: Presepsin represents a promising biomarker for the early diagnosis and severity assessment of sepsis, with particularly relevant diagnostic utility in adult critically ill patients. Its ability to distinguish infectious from non-infectious organ dysfunction and its association with septic shock and mortality further support its potential clinical application. Nevertheless, variability in cutoff values, assay methods, patient characteristics, and diagnostic criteria highlights the need for standardized thresholds and further multicenter validation before widespread integration into routine sepsis diagnostic algorithms.