An evaluation of clinical inflammatory and coagulation markers in patients with sepsis: a pilot study

Acute Med Surg. 2019 Mar 1;6(2):158-164. doi: 10.1002/ams2.397. eCollection 2019 Apr.

Abstract

Aim: Presepsin values could assist early diagnosis and prognosis of sepsis. In sepsis, prognosis is determined according to multiple organ dysfunction, where coagulopathy is common and associated with prognosis. This study aimed to determine the correlation between presepsin value trend and prognosis, and investigate coagulation abnormality in sepsis.

Methods: We retrospectively examined 18 intensive care unit patients diagnosed with sepsis whose presepsin values at admission were ≥500 ng/mL. If presepsin values had decreased ≥50% on hospital day 6, compared to admission values, the patient was allocated into a decreased presepsin group.

Results: Presepsin values in non-survivors with sepsis were significantly higher than in survivors on day 6 (P = 0.022). No significant differences in procalcitonin or C-reactive protein were identified between survivors and non-survivors, and platelet counts were significantly lower in non-survivors on days 0, 3, and 6 (P = 0.001, P < 0.001, and P = 0.001, respectively). The 90-day mortality rate in a decreased presepsin group significantly improved, even when presepsin values were high on admission (P = 0.012). Platelet counts were significantly lower on all hospital days in the non-decreased presepsin group.

Conclusion: Fifty percent decrease in presepsin levels could be a useful prognostic predictor of sepsis. Larger studies are required to confirm our findings.

Keywords: C‐reactive protein; platelet count; presepsin; procalcitonin; prognosis.