Accuracy of Pancreatic Stone Protein for diagnosis of sepsis in children admitted to pediatric intensive care or high-dependency care: a pilot study

Abstract

Abstract Background Pancreatic Stone Protein (PSP) is one of the most promising diagnostic and prognostic marker. The aim of the study was to assess the accuracy of PSP, compared to C-Reactive Protein (CRP), and Procalcitonin (PCT) for diagnosis of sepsis in pediatric patients. Furthermore, we explored the correlation of PSP levels with sepsis severity and organ failure measured with PELOD-2 score. Methods 40 pediatric patients were enrolled following admission to pediatric intensive care, high dependency care or pediatric ward. Blood levels of PSP were measured in Emergency Department (nanofluidic point-of-care immunoassay; abioSCOPE, Abionic SA, Switzerland) on day 1, 2, 3, 5 and 7 from the onset of the clinical signs and symptoms of sepsis or SIRS. Inclusion criteria were: 1) patient age (1 month to 18 years old), 2) signs and symptoms of SIRS, irrespective of association with organ dysfunction. Exclusion criteria were: 1) hemato-oncological diseases and/or immunodeficiencies, 2) pancreatic diseases. Results Septic patients showed higher PSP levels than patients with systemic inflammation of no infectious etiology. The optimal cut off in diagnosis of sepsis for PSP at day 1 was 167 ng/ml resulted in a sensitivity 59% (95% IC 36% − 79%) and a specificity 83% (95% IC 58%-96%) with an AUC of 0.636 for PSP in comparison AUC of 0.722 for PCT and 0.503 for C-RP. ROC analysis for outcome (survival versus no survival) has showed AUC 0.814 for PSP; AUC 0.814 for PCT; AUC of 0.657 for C-RP. Conclusions PSP could distinguish sepsis cases versus systemic inflammation of no infective etiology; however, our results need to be confirmed in larger pediatric population.