The value of Presepsin(sCD-14) combined with arterial lactate for predicting the prognosis of patients with sepsis

Quan Jin-hua; Cui Yan; Zhang Xin-chao

doi:10.3969/j.issn.1002-1949.2017.08.002

Abstract：Objective To investigate the value of serum soluble leukocyte differentiation antigen 14 subtype (sCD14-ST, Presepsin) combined with arterial lactate for predicting the prognosis of emergency patients with sepsis.Methods We selected 90 patients who came to the emergency department of Beijing Hospital with sepsis from September 2009 to July 2015 as the objects of the study.The serum samples were collected immediately as they came, the Presepsin and lactate were measured.Patients were divided into survival group (57 cases) and death group (33 cases) according to the 30-day prognosis, and the value of the Presepsin, lactate and Presepsin + lactate in the assessment of prognosis were compared.Univariate and multivariate logistic regression analysis were used to analyze the prognostic factors of sepsis patients, and ROC curve to evaluate the prognostic value of serum Presepsin and lactate levels.Results Presepsin and lactate both were higher in the death group than the survival group [1323.0 (942.5, 2304.0) vs.547.0 (297.5, 904.0), P<0.05;3.5 (1.7, 5.8) vs.1.2 (0.8, 2.0), P<005].Univariate and multivariate Logistic regression analysis showed that Presepsin and lactate were independent risk factors for death in patients with sepsis, the OR and CI were 1.002 (1.001, 1.003) and 2.343 (1.428, 3.845), respectively.Under the ROC curve area (AUC) of Presepsin and lactate were 0.829 and 0.848.The combination of Presepsin and lactate was 0.900.When Presepsin≥ 927.5 pg/mL and lactate≥2.35 mmol/L, it can significantly improve the efficacy of predicting prognosis.Conclusion Serum Presepsin is a good indicator to judge the prognosis of patients with sepsis, and the combination with lactate can improve the ability to predict the risk of septic death.