Presepsin in the Rapid Response System for Cancer Patients: A Retrospective Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Statistical Analyses
3. Results
3.1. Patient Demographics
3.2. Markers of Septic Shock and Mortality Risk
3.3. Markers of Septic Shock in Patients with/without Acute Kidney Injury
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Variable | Number of Patients (%) (n = 74) |
---|---|
Sex | |
Male | 41 (55.4%) |
Female | 33 (44.6%) |
Age | 64.6 (13.6%) |
Cancer type | |
Hepatobiliary and pancreatic cancer | 19 (25.6%) |
Gastrointestinal cancer | 14 (18.9%) |
Gynecological cancer | 11 (14.8%) |
Urological cancer | 10 (13.5%) |
Lung cancer | 10 (13.5%) |
Hematologic malignancy | 6 (8.1%) |
Others | 4 (4.9%) |
Cancer stage | |
Locally advanced cancer | 53 (71.6%) |
Metastatic cancer | 21 (28.4%) |
ICU transfer | 64 (86.5%) |
Yes | 10 (13.5%) |
No | |
Diagnosis at RRS activation | |
Sepsis | 17 (23.0%) |
Septic shock | 27 (36.5%) |
Other shock | 21 (28.4%) |
Respiratory failure | 7 (9.5%) |
Others | 2 (2.7%) |
Pre-existing condition | |
Chemotherapy within 30 days | 53 (71.6%) |
Cardiovascular disease | 10 (13.5%) |
With acute kidney injury | 21 (28.3%) |
Intervention in place | |
Continuous vasoactive agent use | 44 (59.5%) |
Mechanical ventilator use | 21 (28.4%) |
Continuous renal replacement therapy | 14 (18.9%) |
Mortality | 29 (39.2%) |
Variable | Cut off | Sensitivity (95% CI) | Specificity (95% CI) |
---|---|---|---|
Septic shock | |||
WBC | 12,000 | 59.3 | 40.4 |
CRP | 1.0 | 96.3 | 6.4 |
Lactic acid | 19.8 | 70.4 | 57.4 |
Presepsin | 728 | 74.1 | 51.1 |
Mortality | |||
WBC | 12,000 | 51.7 | 35.6 |
CRP | 1.0 | 96.6 | 6.7 |
Lactic acid | 19.8 | 69.0 | 57.8 |
Presepsin | 727 | 72.4 | 48.9 |
Variable | Cut off | Non-Septic Shock (n = 47) | Septic Shock (n = 27) | p-Value * |
---|---|---|---|---|
Septic shock | 0.918 | |||
WBC | <12,000 | 19 | 11 | |
≥12,000 | 28 | 16 | ||
CRP | <1.0 | 3 | 1 | 0.441 |
≥1.0 | 44 | 26 | ||
Lactic acid | <19.8 | 27 | 8 | 0.012 |
≥19.8 | 20 | 19 | ||
Presepsin | <728 | 24 | 7 | 0.079 |
≥728 | 23 | 20 | ||
Mortality | ||||
WBC | <12,000 | 16 | 14 | 0.397 |
≥12,000 | 29 | 15 | ||
CRP | <1.0 | 3 | 1 | 1.000 |
≥1.0 | 42 | 28 | ||
Lactic acid | <19.8 | 26 | 9 | 0.044 |
≥19.8 | 19 | 20 | ||
Presepsin | <727 | 22 | 8 | 0.114 |
≥727 | 23 | 21 |
Variable | Normal Kidney Function | With AKI | ||
---|---|---|---|---|
Sensitivity (95% CI) | Specificity (95% CI) | Sensitivity (95% CI) | Specificity (95% CI) | |
Septic shock | ||||
Lactic acid | 55.6 (30.8–78.5) | 60 (42.1–76.1) | 100 (66.4–100) | 50 (21.1–78.9 |
Presepsin | 61.1 (35.7–82.7) | 62.9 (44.9–78.5) | 100 (66.4–100) | 25 (5.5–57.2) |
Mortality | ||||
Lactic acid | 60 (36.1–80.9) | 63.6 (45.1–79.6) | 88.9 (51.8–99.7) | 41.7 (15.2–72.3) |
Presepsin | 65 (40.8–84.6) | 60.6 (42.1–97.2) | 77.8 (40–97.2) | 50 (21.1–78.9) |
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Lee, M.-J.; Han, W.-H.; Chun, J.-Y.; Kim, S.-Y.; Kim, J.-H. Presepsin in the Rapid Response System for Cancer Patients: A Retrospective Analysis. J. Clin. Med. 2021, 10, 2153. https://doi.org/10.3390/jcm10102153
Lee M-J, Han W-H, Chun J-Y, Kim S-Y, Kim J-H. Presepsin in the Rapid Response System for Cancer Patients: A Retrospective Analysis. Journal of Clinical Medicine. 2021; 10(10):2153. https://doi.org/10.3390/jcm10102153
Chicago/Turabian StyleLee, Min-Jung, Won-Ho Han, June-Young Chun, Sun-Young Kim, and Jee-Hee Kim. 2021. "Presepsin in the Rapid Response System for Cancer Patients: A Retrospective Analysis" Journal of Clinical Medicine 10, no. 10: 2153. https://doi.org/10.3390/jcm10102153