Journal of Personalized Medicine Article Presepsin as a Potential Prognostic Marker for Sepsis According to Actual Practice Guidelines Alice Nicoleta Drăgoescu 1 , Vlad Pădureanu 2, * , Andreea Doriana Stănculescu 1, *, Luminit , a Cristina Chiut , u 1 , Dan Nicolae Florescu 3 , Ioana Andreea Gheonea 4 , Rodica Pădureanu 5 , Alex Stepan 6 , Costin Teodor Streba 7 , Andrei Ioan Drocas , 8 , Adriana Mihaela Ciocâlteu-Ionescu 3 , Valeriu Marin S , urlin 9 and Octavian Petru Drăgoescu 8   Citation: Dr˘ agoescu, A.N.; P˘ adure- anu, V.; St˘ anculescu, A.D.; Chiut , u, L.C.; Florescu, D.N.; Gheonea, I.A.; P˘ adure- anu, R.; Stepan, A.; Streba, C.T.; Drocas , , A.I.; Ciocâlteu-Ionescu, A.M.; et al. Pre- sepsin as a Potential Prognostic Marker for Sepsis According to Actual Prac- tice Guidelines. J. Pers. Med. 2021, 11, 2. https://dx.doi.org/10.3390/jpm 11010002 Received: 3 November 2020 Accepted: 20 December 2020 Published: 22 December 2020 Publisher’s Note: MDPI stays neu- tral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2020 by the authors. Li- censee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/ licenses/by/4.0/). 1 Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; alice.dragoescu@yahoo.com (A.N.D.); luminita.chiutu@gmail.com (L.C.C.) 2 Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania 3 Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; nicku_dan@yahoo.co.uk (D.N.F.); adriana_ciocalteu@yahoo.com (A.M.C.-I.) 4 Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; iagheonea@gmail.com 5 Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; zegheanurodica@yahoo.com 6 Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; astepan76@yahoo.com 7 Department of Research Methodology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; costinstreba@gmail.com 8 Department of Urology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; andrei_drocas@yahoo.com (A.I.D.); pdragoescu@yahoo.com (O.P.D.) 9 Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; vsurlin@gmail.com * Correspondence: vldpadureanu@yahoo.com (V.P.); stanculescu.andreea@yahoo.com (A.D.S.) Abstract: The 2016 Surviving Sepsis Campaign guidelines define sepsis as life-threatening organ dys- function caused by a dysregulated host response to infection. This study had the objective of assessing the efficacy of presepsin in the prognosis of sepsis. This was a single-center prospective study, performed in Craiova Emergency Hospital, that included 114 patients admitted in the Intensive Care Unit (ICU) department between 2018 and 2019 fulfilling the sepsis criteria. Including criteria were: age ≥ 18, sepsis diagnosed by the Sequential Organ Failure Assessment (SOFA) score of pulmonary, abdominal, urinary, surgical or unknown origin, as well as lactate levels ≥ 2 mmol/l and need of vasopressors for mean arte- rial pressure (MAP) ≥ 65 mmHg, despite adequate volume resuscitations for patients with septic shock. Patients younger than 18, pregnant, immunocompromised, or with terminal illnesses were excluded. Based on disease severity, patients were distributed into two study groups: sepsis—76 patients and septic shock—38 patients. As expected, SOFA score and most of its components (PaO 2 /FiO 2 , platelets, and Glasgow Coma Score (GCS)) were significantly modified for patients with septic shock compared to those in the sepsis group and for survivors versus non-survivors. Overall death rate was 34.2%, with a significantly higher value for patients with septic shock (55.3% vs. 23.7%, p = 0.035). Sepsis marker presepsin was significantly elevated in all patients (2047 ng/mL) and significantly increased for the septic shock patients (2538 ng/mL, p < 0.001) and non-survivors (3138 ng/mL, p < 0.001). A significant correlation was identified between the SOFA score and presepsin (r = 0.883, p < 0.001). The receiver operating characteristics (ROC)-Area Under Curve (AUC) analysis showed significant prognostic values for presepsin regarding both sepsis severity (AUC = 0.726, 95% confidence interval CI = 0.635–0.806) and mortality risk (AUC = 0.861, 95%CI = 0.784–0.919). In conclusion, under the revised definition of sepsis, presepsin could be a useful marker for prognosis of sepsis severity and mortality risk. Additional data are required to confirm the value of presepsin in sepsis prognosis. Keywords: sepsis; septic shock; prognosis; presepsin J. Pers. Med. 2021, 11, 2. https://dx.doi.org/10.3390/jpm11010002 https://www.mdpi.com/journal/jpm