B-110 Combination of Presepsin, HE4 and Oxygenation index as a biomarker for sepsis diagnosis and prognosis prediction among the intensive care unit

Abstract Background Early screening potential sepsis is the key points for clinician to implement the promptly medical treatment. In this study, we aimed to evaluate the diagnostic and prognostic value of Presepsin, HE4, OI (Oxygenation index, PaO2/FiO2), and combined indicator (Presepsin+HE4+OI, PHO) in patients with sepsis in the ICU. Methods A total of 411 patients were enrolled (165 Non-sepsis and 246 sepsis) in the ICU of the First Affiliated Hospital of Sun Yat-Sen University (Guangzhou, China) from May 2021 to May 2022. Clinical data, laboratory indicators, and blood samples were collected at admission of hospitalization. Presepsin and HE4 were measured by chemiluminescent microparticle immunoassay. ROC curve analysis and Spearman*s correlation were used to evaluate the value of Presepsin, HE4, OI and PHO in the diagnosis and prognosis of sepsis. Results The levels of Presepsin, HE4 and OI in sepsis group were significantly higher than those in non-sepsis group (all P<0.05), and the levels of Presepsin, HE4 and OI were positively correlated with 30-day mortality in sepsis patients. For the diagnosis of sepsis, the AUCs of Presepsin, HE4 and combined indicator PHO were higher than that of other laboratory infection indicators, and the AUC of combined indicator PHO was higher than that of Presepsin, HE4, OI alone. For the prognosis of sepsis, ROC curve analysis showed that the AUC of Presepsin, HE4, OI and combined indicator PHO were 0.652 (95% CI: 0.586-0.725), 0.657 (95% CI: 0.587-0.726), 0.649 (95% CI: 0.583-0.720), and 0.706 (95% CI: 0.641-0.772), respectively. Conclusion For sepsis patients, Presepsin, HE4 and OI all have high diagnostic and prognostic value, and the combined indicator PHO outperforms the single index in diagnostic and prognostic performance.