A Prospective Study of Presepsin as an Indicator of the Severity of Community-Acquired Pneumonia in Emergency Departments: Comparison with Pneumonia Severity Index and CURB-65 Scores

Despite widely used severity indices such as the pneumonia severity index (PSI) and CURB-65, a rapid, easy-to-detect biological marker is required for assessment of community-acquired pneumonia (CAP) severity. We aimed to investigate the ability of presepsin to differentiate between high- and low-risk patients, categorized according to PSI and CURB-65 scores. This prospective study was performed in an emergency department (ED) with 90 CAP patients. Whole blood presepsin levels were measured with a point-of-care test instrument. 
Using PSI and CURB-65 scores, we classified patients into outpatient (low-score group of PSI and CURB-65) and inpatient (high-score group of PSI and CURB-65) management groups. Presepsin levels were significantly higher in CAP patients with the high-score groups compared to the corresponding low-score groups. Presepsin correlated well with low- and high-score PSI (ROC AUC: presepsin, 0.726; PCT, 0.614; CRP, 0.544) and CURB-65 groups (ROC AUC: presepsin, 0.669; PCT, 0.645; CRP, 0.602). Presepsin is a valuable  biomarker for assessing and classifying CAP severity.