Serial monitoring of pancreatic stone protein for the detection of sepsis in intensive care unit patients with complicated abdominal surgery: A prospective, longitudinal cohort study

Paraskevas Filippidis; Leana Hovius; Frederic Tissot; Christina Orasch; Ursula Flückiger; Martin Siegemund; Jean-Luc Pagani; Philippe Eggimann; Oscar Marchetti; Frederic Lamoth; Fungal Infection Network of Switzerland (FUNGINOS)

doi:10.1016/j.jcrc.2024.154772

Serial monitoring of pancreatic stone protein for the detection of sepsis in intensive care unit patients with complicated abdominal surgery: A prospective, longitudinal cohort study

J Crit Care. 2024 Mar 11:82:154772. doi: 10.1016/j.jcrc.2024.154772. Online ahead of print.

Affiliations

¹ Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
² University of Lausanne, Lausanne, Switzerland.
³ Medisyn, Lucerne, Switzerland; Division of Infectious Diseases and Hospital Epidemiology, Department of Medicine, University Hospital of Basel, Basel, Switzerland.
⁴ Division of Infectious Diseases and Hospital Epidemiology, Department of Medicine, University Hospital of Basel, Basel, Switzerland; Department of Medicine, Hirslanden Klinik, Aarau, Switzerland.
⁵ Intensive Care Unit, University Hospital of Basel, Basel, Switzerland.
⁶ Adult Intensive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁷ Department of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁸ Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Medicine, Ensemble Hospitalier de la Côte, Morges, Switzerland.
⁹ Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Microbiology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address: Frederic.Lamoth@chuv.ch.

PMID: 38471247
DOI: 10.1016/j.jcrc.2024.154772

Abstract

Purpose: The objective of this study was to assess the performance of pancreatic stone protein (PSP) monitoring for the detection of sepsis, prediction of outcome and distinction between bacterial and fungal infections in intensive care unit (ICU) patients with complicated abdominal surgery.

Materials and methods: In this prospective multicenter cohort study, patients with complicated abdominal surgery had serial PSP measurements during their ICU stay. Infectious episodes were classified as bacterial, fungal or mixed. PSPmax (maximal PSP value within 48 h of the diagnosis of infection) and ΔPSP (difference between PSPmax and the preceding PSP value) were used for analyses.

Results: PSPmax was obtained for 118 infectious episodes (68 patients). ΔPSP was available for 73 episodes (48 patients). Both PSPmax and ΔPSP were significantly higher in patients with sepsis and in patients with a fatal outcome. A PSPmax ≥124 ng/ml and a ΔPSP ≥34 ng/ml could detect sepsis with a sensitivity/specificity of 84%/54% and 69%/76%, respectively. There was no significant difference of PSPmax or ΔPSP between patients with bacterial/mixed versus fungal infections.

Conclusions: Serial PSP monitoring may be an additional tool for the early detection of sepsis in patients with complicated abdominal surgery who are at high risk of severe infections.

Keywords: Biomarker; Candida; Lithostathine; Outcome; Peritonitis; sepsis.