Plasma presepsin as a predictor of mortality in patients with UTI-related severe infection: a single-center retrospective study

This study aimed to evaluate whether plasma presepsin levels are a more reliable predictor of mortality than traditional infection biomarkers in patients with urinary tract infection (UTI)-related severe infection. This single-center retrospective study evaluated 69 patients with UTI-related severe infection admitted to the emergency department between May 2022 and August 2023. Data on vital signs, plasma presepsin levels, procalcitonin (PCT) levels, C-reactive protein (CRP) levels, white blood cell (WBC) count, and other laboratory values at admission were collected. The values of presepsin, PCT, CRP, and WBC count for predicting 28-day mortality were analyzed. Survivors and non-survivors were propensity score-matched in a 2:1 ratio based on age, sex, and estimated glomerular filtration rate. In the overall cohort, presepsin showed the highest area under the receiver operating characteristic curve (AUROC) of 0.716 for predicting 28-day mortality, surpassing that of PCT (0.641), CRP (0.488), and WBC count (0.433). Presepsin levels were independently associated with increased 28-day mortality risk (hazard ratio, 1.026; p = 0.008). In the matched cohort, presepsin levels showed the highest AUROC (0.660), followed by PCT (0.584), CRP (0.496), and WBC count (0.436). Presepsin levels were independently associated with increased 28-day mortality risk; this may be a valuable biomarker for identifying high-risk patients with UTI-related severe infection.