Eftychios Lostoridis1*, Georgios S Sioutas2, Spyridon Miliaras3, Georgios Marakis3 and Georgios Tsoulfas4
1Department of Surgery, Kavala General Hospital, Greece
2School of Health Sciences, Democritus University of Thrace, Greece
3First Department of Surgery, Aristotle University of Thessaloniki, School of Medicine, Greece
4Department of Transplantation Surgery, Aristotle University of Thessaloniki, School of Medicine, Greece
Background: Current evidence indicates that sCD14-ST (presepsin) is increased in sepsis. However, the potential role of presepsin for diagnosing appendicitis remains unclear. This study aims to investigate the diagnostic value of presepsin in patients with appendiceal inflammation. Materials and Methods: This prospective, multi-center study was conducted between August 2015 and December 2017, including 41 patients with suspected appendicitis and 41 controls. Blood samples were collected to assess presepsin, C-reactive protein, fibrinogen, white blood cells, neutrophils, creatinine and gamma-glutamyl transferase. Patients underwent appendicectomy, and specimens were sent for histopathology. A receiver operating characteristic curve assessed the optimal cutoff, sensitivity, and specificity of presepsin to diagnose appendicitis. Results: In patient group, pathology was positive for appendicitis in 92.7% (catarrhoic: 19.5%, suppurative: 36.6%, and gangrenous: 36.6%). Peritoneal fluid culture was positive in 17.1%, with the most common pathogen being Escherichia coli. Presepsin levels were elevated to appendicitis group in comparison with controls (p<0.001). There was a statistically significant correlation between presepsin and neutrophils (r=0.367, p=0.018) among appendicitis patients. Moreover, presepsin levels were marginally related to pathology (p=0.060), but gangrenous appendicitis patients had significantly higher levels of presepsin in comparison to suppurative ones. According to ROC analysis, presepsin can predict the inflammation of the appendix with 81% sensitivity and 76% specificity (cutoff 200.5 pg/ml, AUC 0.858 [SE: 0.039; 95% CI: 0.78-0.94; p<0.001]). Conclusion: Serum presepsin is a valuable, diagnostic parameter to predict inflammation of appendiceal appendage, especially for gangrenous cases. However, larger studies are needed to evaluate sCD14-ST in early stages of appendicitis.
Lostoridis E, Sioutas GS, Miliaras S, Marakis G, Tsoulfas G. The Diagnostic Value of sCD14-ST (Presepsin) in Acute Appendicitis. Clin Surg. 2022; 7: 3583.