Combined estimation of presepsin and gelsolin might improve the diagnostic validity of clinical scoring to predict and stratify sepsis in non-sepsis surgical ICU patient

Objectives
This study evaluates the ability of serum presepsin (PSEP) and gelsolin (GSN) levels estimated in blood samples obtained at the admission of sepsis-free patients to surgical ICU (SICU) as early predictors for getting sepsis and sepsis-related complications.
Patients & Methods
260 sepsis-free trauma and postoperative patients who were admitted to SICU were clinically evaluated. At-admission blood samples were obtained for total and differential leucocytic counting and ELISA estimation of serum C-reactive protein (CRP), procalcitonin (PCT), PSEP and GSN, and PSEP/GSN ratio was calculated (PGR). Patients were observed for the SICU readmission rate after being ward-discharged for the sepsis rate and mortality rate (MR).
Results
The SICU readmission rate was 7.2%, the sepsis rate was 25.4%, and the sepsis-related MR was 5%. The estimated biomarkers were significantly higher in patients than negative controls but were lower than positive controls except serum levels of GSN that were significantly lower in patients’ samples than in negative, but higher than in positive controls. Statistical analyses defined high serum PSEP and lower serum GSN levels with high PGR as significant predictors for all the study outcomes.
Conclusion
Among sepsis-free patients who are admitted to SICU, getting septic complications is not an uncommon event and accounts for 5% of SICU mortalities. Estimated serum levels of PSEP and GSN might be valuable biomarkers for early distinguishing patients vulnerable to developing septic complications and predicting the possibility of non-surviving. The calculated PSEP/GSN ratio might be a collective early indicator for outcomes of patients admitted to SICU.