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- Usefulness of presepsin as a prognostic indicator for patients with trauma in the emergency department in Korea: a retrospective study
- Si Woo Kim, Jung-Youn Kim, Young-Hoon Yoon, Sung Joon Park, Bo Sun Shim
- J Trauma Inj. 2024;37(1):13-19. Published online January 12, 2024
- DOI: https://doi.org/10.20408/jti.2023.0061
- 638 View
- 16 Download
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Abstract
PDF - Purpose
Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma.
Methods
The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed.
Results
Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8–79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041).
Conclusions
Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home. -
Summary
- Significance of Biomarkers as a Predictive Factor for Post-Traumatic Sepsis
- Kyung-Wuk Lee, Sung-Hyuk Choi, Young-Hoon Yoon, Jung-Youn Kim, Young-Duck Cho, Han-Jin Cho, Sung-Jun Park
- J Trauma Inj. 2018;31(3):166-173. Published online December 31, 2018
- DOI: https://doi.org/10.20408/jti.2018.027
- 2,953 View
- 42 Download
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Abstract
PDF
Purpose Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients.
Methods This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient’s blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week.
Results A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ≥15). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (
p <0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p <0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups.Conclusions MIF may be considered as a predictive factor for sepsis in trauma patients.
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