Presepsin as a biomarker for risk stratification for acute cholangitis in emergency department: A single-center study

Table 1 Clinical features and results of 336 cases of acute cholangitis analyzed according to disease severity classified by the Tokyo guidelines 2018: Diagnostic criteria and severity grading of acute cholangitis

	Acute cholangitis (n = 336)	Severity of acute cholangitis			P value
		Mild (n = 107)	Moderate (n = 106)	Severe (n = 123)
Features
Age (yr)	75 (66-84)	69 (64-79)	81 (70-86)	75 (67-85)	0.000
Male/female	198/138	61/46	65/41	72/51	0.810
Temperature (℃)	38.5 (37.7-39.3)	38.2 (37.5-39.0)	38.6 (37.8-39.4)	38.6 (37.7-39.7)	0.021
MAP (kPa)	11.4 (10.1-12.7)	11.6 (10.1-12.6)	11.6 (10.5-12.8)	11.2 (9.4-12.7)	0.055
Laboratory test
WBCs (× 109/L)	10.52 (7.32-14.78)	8.70 (6.19-11.06)	13.08 (8.97-16.27)	11.24 (7.36-15.45)	0.000
CRP (mg/L)	83.71 (43.17-152.86)	54.86 (21.36-111.00)	85.11 (53.17-148.70)	116.92 (60.00-175.13)	0.000
PCT (ng/mL)	9.93 (1.93-36.38)	4.64 (0.96-13.31)	9.58 (1.33-33.41)	22.88 (4.15-51.70)	0.000
Presepsin (pg/mL)	2159.50 (1477.25-3214.50)	1376.00 (865.00-1989.00)	2150.50 (1757.75-2603.00)	3179.00 (2214.00-3862.00)	0.000
T-Bil (µmol/L)	93.98 (57.06-144.26)	64.06 (47.90-105.86)	111.84 (88.06-153.27)	101.81 (60.77-145.04)	0.000
D-Bil (µmol/L)	66.89 (37.29-97.33)	42.65 (30.30-78.95)	76.60 (58.67-100.71	70.13 (40.37-98.56)	0.000
Total protein (g/L)	66.5 (59.9-71.9)	68.2 (63.5-72.3)	67.8 (61.5-72.9)	62.0 (57.1-68.8)	0.000
Albumin (g/L)	33.9 (30.6-37.8)	35.4 (31.7-39.8)	35.4 (31.5-38.6)	32.0 (29.2-36.1)	0.000
ALT (U/L)	147.5 (75.0-266.5)	153.0 (60.0-311.0	150.0 (88.4-298.3)	139.0 (75.0-240.0	0.670
AST (U/L)	137.4 (72.1-279.4)	126.5 (64.9-345.5)	142.2 (96.6-276.8)	128.3 (69.7-228.9)	0.367
LDH (U/L)	243.0 (178.0-352.8)	231.1 (167.0-416.0)	235.5 (169.5-332.0)	254.0 (192.0-356.5)	0.183
SOFA score	5 (3-6)	4 (3-5)	4 (3-5)	7 (5-9)	0.000
Blood culture	312 (92.9%)	97 (90.7%	98 (92.5%)	117 (95.1%)	0.414
Positive blood culture	93 (29.8%)	22 (22.7%)	31 (31.6%)	40 (34.2%)	0.167
G- bacteria	76 (81.7%)	20 (90.9%)	25 (80.6%)	31 (77.5%)	0.418
G+ bacteria	11 (11.8%)	0	4 (12.9%)	7 (17.5%)
Other bacteria	6 (6.5%)	2 (9.1%	2 (6.5%)	2 (5.0%)	0.539
Mortality in 28 d	8 (2.4%)	0	0	8 (6.5%)

Values shown are counts and percentages in parentheses or the median (25^th-75^th percentiles). P < 0.05 was set as the significant level. WBC: White blood cell; MAP: Mean arterial pressure; CRP: C-reactive protein; PCT: Procalcitonin; T-Bil: Total bilirubin; D-Bil: Direct bilirubin; ALT: Alanine amino transferase; AST: Aspartate amino transferase; LDH: Lactated hydrogenase; SOFA score: Sequential organ failure assessment scores. G^-: Gram-negative; G⁺: Gram-positive.

Table 2 Correlations of Tokyo Guidelines 2018 grade and sequential organ failure assessment scores with white blood cells, C-reactive protein, procalcitonin, presepsin, and total bilirubin

Correlation	TG18 grade		SOFA scores
	Correlation coefficient	P value	Correlation coefficient	P value
WBCs	0.232	0.000	0.713	0.001
CRP	0.285	0.000	0.319	0.000
PCT	0.041	0.453	0.127	0.020
Presespin	0.324	0.000	0.384	0.000
T-Bil	0.057	0.301	0.173	0.001
SOFA	0.555	0.000

P value < 0.05 was set as the significant level. TG18: Tokyo guidelines 2018: Diagnostic criteria and severity grading of acute cholangitis; CRP: C-reactive protein; PCT: Procalcitonin; T-Bil: Total bilirubin; SOFA scores: Sequential organ failure assessment scores.