Abstract

Background: Timely identification of sepsis in critically ill patients remains challenging. Commonly used biomarkers, including C-reactive protein (CRP) and procalcitonin (PCT), show suboptimal diagnostic performance. Pancreatic stone protein (PSP) has recently been proposed as an early indicator of infection and sepsis. Methods: We performed a retrospective observational study involving 90 adult ICU patients, including septic and non-septic patients selected during the study period. Sepsis was defined according to Sepsis-3 criteria. Diagnostic accuracy was evaluated using receiver operating characteristic curves, and sensitivity, specificity, and predictive values were calculated. The association between PSP levels and in-hospital mortality was examined using multivariable logistic regression analysis. Results: Of the 90 patients included, 45 (50%) were diagnosed with sepsis. PSP levels were significantly higher in septic patients compared to non-septic patients (210 (175–265) vs. 105 (80–135) ng/mL; p < 0.001). PSP demonstrated the best diagnostic performance among the evaluated biomarkers (AUC 0.88, 95% CI 0.81–0.94), compared with PCT (0.82) and CRP (0.74). At a threshold of 150 ng/mL, PSP showed a sensitivity of 84% and a specificity of 80%. Higher PSP values were independently associated with increased in-hospital mortality and longer ICU stay. Conclusions: PSP appears to be a useful biomarker for early identification of sepsis in critically ill non-surgical patients, with better diagnostic performance than CRP and PCT. Its incorporation into clinical assessment may support earlier recognition and improved risk stratification. Further multicenter studies are needed to confirm these findings and to better define its role in clinical decision-making.

IPC Classification

Keywords