Serial monitoring of pancreatic stone protein for the detection of sepsis in intensive care unit patients with complicated abdominal surgery: A prospective, longitudinal cohort study

• Published in: Journal of critical care 2024-08, Vol.82, p.154772, Article 154772
• Main Authors: Filippidis, Paraskevas, Hovius, Leana, Tissot, Frederic, Orasch, Christina, Flückiger, Ursula, Siegemund, Martin, Pagani, Jean-Luc, Eggimann, Philippe, Marchetti, Oscar, Lamoth, Frederic
• Format: Article
• Language: English
• Subjects: Abdomen; Abdomen - surgery; Abdominal surgery; Aged; Biomarker; Biomarkers - blood; Candida; Cohort analysis; Ethics; Female; Fungal infections; Humans; Intensive care; Intensive Care Units; Lithostathine; Lithostathine - blood; Longitudinal Studies; Male; Middle Aged; Mortality; Outcome; Pancreatitis; Patients; Peritonitis; Postoperative Complications - diagnosis; Prospective Studies; Proteins; Sensitivity and Specificity; Sepsis; Sepsis - blood; Sepsis - diagnosis; Surgical anastomosis
• ISSN: 0883-9441; 1557-8615; 1557-8615
• DOI: 10.1016/j.jcrc.2024.154772

The objective of this study was to assess the performance of pancreatic stone protein (PSP) monitoring for the detection of sepsis, prediction of outcome and distinction between bacterial and fungal infections in intensive care unit (ICU) patients with complicated abdominal surgery. In this prospective multicenter cohort study, patients with complicated abdominal surgery had serial PSP measurements during their ICU stay. Infectious episodes were classified as bacterial, fungal or mixed. PSPmax (maximal PSP value within 48 h of the diagnosis of infection) and ΔPSP (difference between PSPmax and the preceding PSP value) were used for analyses. PSPmax was obtained for 118 infectious episodes (68 patients). ΔPSP was available for 73 episodes (48 patients). Both PSPmax and ΔPSP were significantly higher in patients with sepsis and in patients with a fatal outcome. A PSPmax ≥124 ng/ml and a ΔPSP ≥34 ng/ml could detect sepsis with a sensitivity/specificity of 84%/54% and 69%/76%, respectively. There was no significant difference of PSPmax or ΔPSP between patients with bacterial/mixed versus fungal infections. Serial PSP monitoring may be an additional tool for the early detection of sepsis in patients with complicated abdominal surgery who are at high risk of severe infections. •PSP may contribute to the detection of sepsis in patients with abdominal surgery.•PSP may be a predictor of outcome in infected, critically-ill patients.•PSP was not able to distinguish bacterial from fungal infectious complications.