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The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers
Eun Yeong Ha1, Il Rae Park1, Seung Min Chung1
1Department of Internal Medicine, Yeungnam University Medical Center, Daegu 42415, Republic of Korea.
Insights
Presepsin shows promise as an early indicator for severe diabetic foot ulcer infections, helping predict the need for amputation. This marker aids in timely detection and treatment of serious diabetic foot complications.
Area of Science:
- Biomarkers and Infectious Diseases
- Diabetic Complications Research
Background:
- Diabetic foot ulcers are a significant complication of diabetes, often caused by infection, neuropathy, or vascular issues.
- Infection is the most common cause of diabetic foot ulcers, potentially leading to amputation if not managed promptly.
- Current infection markers lack specificity for diabetic foot ulcers, necessitating the search for more accurate indicators.
Purpose of the Study:
- To investigate the potential of presepsin as an early marker for severe infections in patients with diabetic foot ulcers.
- To determine if presepsin levels can predict the need for amputation due to severe diabetic foot infections.
Main Methods:
- A retrospective study involving 73 patients treated for diabetic foot ulcerations between January 2021 and June 2023.
- Analysis of infection markers including white blood cells (WBCs), erythrocyte sediment rate (ESR), C-reactive protein (CRP), procalcitonin, and presepsin.
- Comparison of marker levels between patients who underwent amputation and those who did not.
Main Results:
- A total of 46 patients required amputation due to severe infections.
- Significantly higher levels of WBC, ESR, CRP, procalcitonin, and presepsin were observed in patients who underwent amputation.
- A presepsin cutoff of 675 ng/mL was identified as predictive of severe infections requiring amputation.
- Regression analysis indicated that presepsin, HbA1c, and osteomyelitis are significant risk factors for severe infections requiring amputation.
Conclusions:
- Presepsin demonstrates potential as an early predictor for severe infections in diabetic foot ulcer patients.
- This marker can help identify patients at high risk of requiring amputation, facilitating timely intervention.
- Further research may establish presepsin as a valuable tool in managing diabetic foot ulcer infections.
Abstract:
Background/Objectives: Diabetic foot ulcers are one of the complications in patients with diabetes, which can be caused by infection, neuropathy, and blood vessel disorder. Among them, infection is the most common cause, and if it becomes worse, amputation may be necessary. So, it is important to detect and treat infections early, and determining indicators that can confirm infection is also important. Known infection markers include white blood cells (WBCs), the erythrocyte sediment rate (ESR), C-reactive protein (CRP), and procalcitonin, but they are not specific to diabetic foot ulcers. Presepsin, also known as soluble CD14, is known to be an early indicator of sepsis. Recent studies have reported that presepsin can be used as an early indicator of infection. This study investigated whether presepsin could be used as an early marker of severe infection in patients with diabetic foot ulcers. Methods: We retrospectively studied 73 patients who were treated for diabetic foot ulcerations from January 2021 to June 2023 at Yeungnam University Hospital. Results: Out of a total of 73 patients, 46 patients underwent amputations with severe infections, and the WBC level, ESR, and CRP, procalcitonin, and presepsin levels were significantly higher in the group of patients who underwent amputations. The cutoff of presepsin, which can predict serious infections that need amputation, was 675 ng/mL. A regression analysis confirmed that presepsin, HbA1c, and osteomyelitis significantly increased the risk of severe infections requiring amputation. Conclusions: Presepsin will be available as an early predictor of patients with severe infections requiring amputations for diabetic foot ulcerations.
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