Prognostic Value of Presepsin, Proadrenomedullin and Interleukin-6 in Sepsis: A Prospective Study From the Emergency Department

Introduction: The objective of this study is to evaluate the predictive value of serum presepsin, proadrenomedullin, and interleukin-6 levels for prognosis and mortality in patients diagnosed with sepsis in the emergency department. Methods: The cross-sectional study was conducted with patients diagnosed with sepsis in the emergency department of a tertiary university hospital.The study analyzed the patients' demographic characteristics, comorbidities, source of sepsis, biomarker levels, treatments, microbial culture results, and 30-day mortality. Blood samples were collected upon the patients' admission to the emergency department. Results: Patients with septic shock had significantly higher serum levels of IL-6 (363.2 pg/mL) compared to those with sepsis (IL-6: 140.6 pg/mL). In contrast, patients with septic shock had significantly lower proadrenomedullin serum levels (0.27 pmol/mL) compared to septic patients (0.48 pmol/mL). Although presepsin levels were slightly higher in the septic shock group (178.3 ng/L) compared to the sepsis group (156.9 ng/L), the difference was not statistically significant. However, the levels of IL-6 were significantly higher in deceased patients (IL-6: 363.2 pg/mL) compared to those who survived (IL-6: 195.5 pg/mL). The ROC analysis results were listed as IL-6 (AUC: 0.701), proadrenomedullin (AUC: 0.658) and procalcitonin (AUC: 0.625) for determining septic shock. Conclusion: Based on the data obtained, interleukin-6, presepsin, and proadrenomedullin respectively are useful biomarkers for predicting and prognosticating sepsis and septic shock in the emergency department. However, none of these biomarkers are independent prognostic predictors for sepsis, septic shock or mortality.