Perioperative presepsin as a potential early predictor for postoperative infectious complications in cardiac surgery


Background: Postoperative infection remains a serious complication of cardiac surgery; however, no existing biomarkers can detect infection in the early perioperative period. We investigated the usefulness of presepsin, a novel biomarker, in predicting postopera- tive infectious complications in cardiac surgery with cardiopulmonary bypass.

Methods: For patients aged > 18 years who underwent elective cardiac surgery with cardiopulmonary bypass between 2015 and 2017, data of clinical features, perioperative presepsin levels, and infectious complications were collected. We compared the periop- erative presepsin levels between the infected and non-infected groups, performed a risk factor analysis for postoperative infection, and calculated the cut-off value of presepsin with postoperative infection.

Results: Among the 73 included patients, 20 developed postoperative infectious com- plications. The presepsin levels pre-operatively and on post-operative day (POD) zero were significantly higher in the infected than in the non-infected group (145.2 vs. 93.2, 514.0 vs. 328.1 [pg mL-1], p < 0.05, respectively). The odds ratio (OR) for postop- erative infection included pre-operative presepsin (OR; 1.22 [confidence interval; 1.07–1.40]/10 pg mL-1) and presepsin on POD zero (OR; 1.31 [confidence interval; 1.05–1.64] /100 pg mL-1). The cut-off predictive values for postoperative infectious com- plications of pre-operative presepsin and on POD zero were 132 and 347 [pg mL-1], re- spectively.

Conclusions: Perioperative presepsin levels could be an early predictor for postopera- tive infectious complications in cardiac surgery.

Key words: cardiac surgery, presepsin, postoperative infection, soluble CD14 sub- type, predictable marker.