Plasma concentration of presepsin and its relationship to the diagnosis of infections in multiple trauma patients admitted to intensive care

Background and aims: Septic complications represent the pre- dominant cause of late death in poly-trauma patients. The necessi- ty to differentiate septic from non septic patients is more relevant at the early stage of the illness in order to improve the clinical out- come and to reduce the mortality. The identification of a sensitive and specific, clinically reliable, biomarker capable to early recog- nize incoming septic complications in trauma patients whose expression is not influenced by concomitant traumatic injuries, is still a challenge for the researchers in the field. patients (9 females and 39 males, mean age 47.6±19 years) with mul- tiple trauma was performed. The inclusion criterion was to suffer from acute trauma since no more than 24 hours and the exclusion cri- teria were the following: antibiotic treatment on admission and main- tained for more than 48 hours; on-going infection on admission not associated with trauma; treatment with immunosuppressors/ immunomodulants; age <18 years old. Presepsin was measured using an automated chemiluminescence analyser at 1, 3, 5 and 8 days post of hospitalization. The diagnosis of systemic inflammatory response syndrome (SIRS)/infection was established according to the criteria of the Surviving Sepsis Campaign. Materials and methods: A retrospective analysis on 48 adult Results and conclusions: In patients with SIRS, the mean pre- sepsin concentration was 917,08 (±69.042) ng/L vs 980,258 (±1951.32) ng/L in patients without SIRS (P=0.769). In the infected patients, the mean presepsin concentration was 1513.25 (±2296.54) ng/L vs 654.21 (±511,068) ng/L (P<0.05) calculated among the non infected upon admission. The plasma presepsin concentration increased progressively during the first 8 days of hospitalization. Presepsin concentration in the infected patients was significantly higher than in non-infected patients. On the other hands no signifi- cant differences were found in the plasma level of presepsin among patients with and without SIRS. Any other clinical condition related to the trauma did not affect presepsin. Our data clearly suggest that presepsin may be considered an helpful diagnostic tool to early diagnose sepsis in trauma patients.