Diagnostic and Prognostic Value of Presepsin in Sepsis: A Prospective Observational Study

Presepsin is hypothesized to be more specific for the diagnosis of sepsis, as it is directly involved in the pathogenesis of the syndrome. Several studies have investigated the clinical validity of presepsin; however, the results have shown considerable variability. The present study aimed to determine the diagnostic accuracy of presepsin as a biomarker for the diagnosis of sepsis.

This prospective observational study included 140 patients, aged 18 years and older, who presented with suspected sepsis, a quick sequential organ failure assessment (qSOFA) score ≥2, and radiological or microbiological evidence of infection. The study was conducted from April 2024 to February 2025 at a tertiary care hospital in Western India. The SOFA score and presepsin levels were measured at the time of presentation. Receiver-operating characteristic (ROC) curve analysis was performed to determine the optimal presepsin cutoff value for predicting sepsis and mortality.

Presepsin levels were significantly higher in patients with sepsis and in those who died. They showed a strong correlation with the SOFA score (r = 0.45; p = 0.01). Receiver-operating characteristic analysis demonstrated that presepsin is a strong predictor of sepsis [area under the curve (AUC) = 0.926 (95% CI: 0.881-0.971; cutoff > 195 pg/mL; sensitivity, 87.2%; specificity, 88.9%]. For mortality, ROC analysis showed good predictive value [AUC = 0.843 (95% CI: 0.755-0.931); cutoff > 1,364 pg/mL; sensitivity, 78.0%; specificity, 80.0%].

Presepsin is a reliable biomarker for the diagnosis and prognosis of sepsis.

Nimbal A, Bahulikar A, Phalgune D, Tambolkar A. Diagnostic and Prognostic Value of Presepsin in Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2026;30(2):117-121.