PMID- 31179081
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 11
IP  - 4
DP  - 2019 Apr
TI  - Impact of initial plasma presepsin level for clinical outcome in hospitalized 
      patients with pneumonia.
PG  - 1387-1396
LID - 10.21037/jtd.2019.03.74 [doi]
AB  - BACKGROUND: Presepsin, the soluble CD14 subtype, is known as a sepsis biomarker. 
      However, its clinical significance in pneumonia is unclear. We investigated the 
      effects of plasma presepsin level on clinical outcomes in patients with 
      pneumonia. METHODS: Patients over 18 years old admitted to our hospital due to 
      pneumonia from May 2016 through November 2017 were reviewed using electronic 
      medical records. One hundred and seventy-two patients who underwent measurement 
      of plasma presepsin levels on admission were enrolled. Median age of enrolled 
      patients was 81 years [interquartile range (IQR), 68-86 years]. Pneumonia 
      severity index (PSI) class and A-DROP score on admission were calculated. The 
      receiver operating characteristic (ROC) curve analysis was performed to assess 
      the prognostic value of 30-day mortality and to identify the optimal cut-off 
      value of plasma presepsin level. Correlations between plasma presepsin level and 
      other factors were assessed using the Spearman's test. The Kaplan-Meier survival 
      analysis and the log-rank test were performed to assess the two curves 
      differentiated with the optimal cut-off value of plasma presepsin level. RESULTS: 
      Seventeen patients (9.9%) died within 30 days of admission. The deceased patients 
      had higher value of plasma presepsin on admission (539 pg/mL; IQR, 414-832 pg/mL) 
      compared with the survivors (334 pg/mL; IQR, 223-484 pg/mL) (P=0.001). The areas 
      under ROC curve for predicting 30-day mortality were 0.742 for plasma presepsin, 
      0.755 for A-DROP score, and 0.774 for PSI class. Plasma presepsin level was not 
      associated with etiology of pneumonia. However, it was moderately correlated with 
      serum creatinine level (rs =0.524, P<0.001). The ROC curve analysis derived 470 
      pg/mL of plasma presepsin level as the optimal cut-off value for predicting 
      30-day mortality. The Kaplan-Meier survival analysis showed that patients with 
      plasma presepsin level >/=470 pg/mL on admission had significantly higher 30-day 
      mortality than those with plasma presepsin level <470 pg/mL (P<0.001). Among 
      patients with A-DROP score >/=3, those with plasma presepsin level >/=470 mg on 
      admission had significantly higher 30-day mortality (P=0.013). Similarly, among 
      patients with PSI class >/=4, those with plasma presepsin level >/=470 mg on 
      admission had significantly higher 30-day mortality (P=0.005). CONCLUSIONS: In 
      hospitalized pneumonia patients, plasma presepsin level on admission could be a 
      useful predictor of 30-day mortality and an additional prognostic biomarker on 
      existing severity assessment scales.
FAU - Ugajin, Motoi
AU  - Ugajin M
AD  - Department of Respiratory Medicine, Nagoya Tokushukai General Hospital, Kasugai 
      City, Aichi Prefecture, Japan.
FAU - Matsuura, Yu
AU  - Matsuura Y
AD  - Department of Internal Medicine, Nagoya Tokushukai General Hospital, Kasugai 
      City, Aichi Prefecture, Japan.
FAU - Matsuura, Kei
AU  - Matsuura K
AD  - Department of Internal Medicine, Nagoya Tokushukai General Hospital, Kasugai 
      City, Aichi Prefecture, Japan.
FAU - Matsuura, Hiroshi
AU  - Matsuura H
AD  - Department of Internal Medicine, Nagoya Tokushukai General Hospital, Kasugai 
      City, Aichi Prefecture, Japan.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC6531740
OTO - NOTNLM
OT  - A-DROP score
OT  - Presepsin
OT  - mortality
OT  - pneumonia
OT  - pneumonia severity index (PSI)
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2019/06/11 06:00
MHDA- 2019/06/11 06:01
PMCR- 2019/04/01
CRDT- 2019/06/11 06:00
PHST- 2019/06/11 06:00 [entrez]
PHST- 2019/06/11 06:00 [pubmed]
PHST- 2019/06/11 06:01 [medline]
PHST- 2019/04/01 00:00 [pmc-release]
AID - jtd-11-04-1387 [pii]
AID - 10.21037/jtd.2019.03.74 [doi]
PST - ppublish
SO  - J Thorac Dis. 2019 Apr;11(4):1387-1396. doi: 10.21037/jtd.2019.03.74.