Related Experiment Video
Updated: Apr 6, 2026
Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
Published on: December 9, 2022
Accuracy of Presepsin in Sepsis Diagnosis: A Systematic Review and Meta-Analysis
Jiayuan Wu1, Liren Hu2, Gaohua Zhang2
1Nutritional Department, The Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, China.
Objective:
It's difficult to differentiate sepsis from non-sepsis, especially non-infectious SIRS, because no good standard exists for proof of infection. Soluble CD14 subtype (sCD14-ST), recently re-named presepsin, was identified as a new marker for the diagnosis of sepsis in several reports. However, the findings were based on the results of individual clinical trials, rather than a comprehensive and overall estimation. Thus, we conducted this systematic review and meta-analysis to estimate the pooled accuracy of presepsin in patients with sepsis suspect.
Methods:
A comprehensive electronic search was performed via internet retrieval system up to 15 December 2014. Methodological quality assessment was applied by using the QUADAS2 tool. The diagnostic value of presepsin in sepsis was evaluated by using the pooled estimate of sensitivity, specificity, likelihood ratio, and diagnostic odds ratio, as well as summary receiver operating characteristics curve.
Results:
Nine studies with 10 trials and 2159 cases were included in the study. Only two trials had low concerns regarding applicability, whereas all trials were deemed to be at high risk of bias. Heterogeneity existed in the non-threshold effect, but not in the threshold effect. The pooled sensitivity of presepsin for sepsis was 0.78 (0.76-0.80), pooled specificity was 0.83 (0.80-0.85), pooled positive likelihood ratio was 4.63 (3.27-6.55), pooled negative likelihood ratio was 0.22 (0.16-0.30), and pooled diagnostic odds ratio was 21.73 (12.81-36.86). The area under curve of summary receiver operating characteristics curve was 0.89 (95%CI: 0.84 to 0.94) and Q* index was 0.82 (95%CI: 0.77 to 0.87).
Conclusion:
This meta-analysis demonstrates that presepsin had some superiority in the management of patients, and may be a helpful and valuable biomarker in early diagnosis of sepsis. However, presepsin showed a moderate diagnostic accuracy in differentiating sepsis from non-sepsis which prevented it from being recommended as a definitive test for diagnosing sepsis in isolation, but the results should be interpreted cautiously.
Insights
This meta-analysis indicates presepsin is a helpful biomarker for early sepsis diagnosis, showing moderate accuracy in distinguishing sepsis from non-sepsis. While valuable, it should not be used as a standalone diagnostic test.
Area of Science:
- Biomarkers
- Infectious Diseases
- Critical Care Medicine
Background:
- Differentiating sepsis from non-infectious systemic inflammatory response syndrome (SIRS) is challenging due to the lack of definitive infection markers.
- Soluble CD14 subtype (sCD14-ST), now known as presepsin, has emerged as a potential biomarker for sepsis diagnosis.
Purpose of the Study:
- To conduct a systematic review and meta-analysis to evaluate the diagnostic accuracy of presepsin in patients with suspected sepsis.
- To provide a comprehensive estimation of presepsin's utility beyond individual clinical trials.
Main Methods:
- A systematic electronic literature search was conducted up to December 15, 2014.
- Methodological quality was assessed using the QUADAS2 tool.
- Diagnostic accuracy was determined by pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and summary receiver operating characteristic (SROC) curve analysis.
Main Results:
- Nine studies comprising 10 trials with 2159 cases were included.
- The pooled sensitivity for sepsis was 0.78 (0.76-0.80) and pooled specificity was 0.83 (0.80-0.85).
- The area under the SROC curve was 0.89, indicating moderate diagnostic accuracy.
Conclusions:
- Presepsin demonstrates potential as a valuable biomarker for the early diagnosis of sepsis.
- While presepsin shows some superiority in patient management, its moderate accuracy limits its use as a definitive standalone diagnostic test for sepsis.
- Results should be interpreted with caution due to identified risks of bias in included trials.
Related Concept Videos
01:13Sensitivity, Specificity, and Predicted Value
Sensitivity is the...
01:30Pneumonia III: Complications and Assessment