J Korean Soc Emerg Med.  2025 Apr;36(2):45-53.

Usefulness of presepsin to predict ICU admission and 28-day mortality in patients with suspected infection in emergency department: retrospective cohort study

• Khang D
• Cho Y
• Sohn Y
• Cho GC

Abstract

Objective
This study examined the predictive values of presepsin compared with that of other biomarkers (C-reactive protein and procalcitonin) for intensive care unit (ICU) admission and the 28-day mortality in patients with a suspected infection presenting to the emergency department (ED).
Methods
This single-center retrospective cohort study was conducted from January 2021 to December 2021 at the ED of a university hospital. The serum presepsin levels were obtained from adult patients suspected of having an infection based on the judgment of clinicians.
Results
Of the 1,772 patients analyzed, 389 patients (22.0%) were admitted to the ICU, and 190 patients (10.7%) died within 28 days. The presepsin levels were significantly higher in the ICU admission group (P<0.001) and non-survivor group (P<0.001) than in the other patients. The receiver operating characteristic (ROC) curve for predicting ICU admission indicated an area under the curve (AUC) of 0.660 for presepsin (vs. 0.640 and 0.700 for the C-reactive protein and procalcitonin, respectively). The ROC curve for predicting the 28-day mortality indicated an AUC of 0.719 for presepsin (vs. 0.675 and 0.720 for C-reactive protein and procalcitonin, respectively).
Conclusion
The initial presepsin level might be useful for predicting ICU admission and 28-day mortality in patients with a suspected infection in the ED.

Keyword

Emergency medicine; Soluble CD-14 subtype; Presepsin; Biomarkers