ArticleInternational journal of general medicine2026
The Inflammation-Presepsin Score as a Predictor of Mortality in Elderly Sepsis Patients (≥75 Years): A Pilot Study.
Article in International journal of general medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The clinical diagnosis and risk stratification of sepsis are particularly challenging in extremely elderly patients (≥75 years) due to atypical presentation and potential diagnostic unreliability of standard scores. This study investigated whether a composite score-presepsin combined with the Prognostic Index (iPS-PI)-offers potential prognostic utility over presepsin alone as a predictor of 28-day mortality, thereby providing a reliable tool for early clinical decision-making in this vulnerable population. Patients and Methods: Eighty-three adult sepsis patients were prospectively examined and stratified into over 75 (n = 41) and under 75 (n = 42) age groups. Presepsin levels and total composite scores (iPS-PI) were calculated upon ICU entry. Statistical analyses, including ROC curve analysis and Cox proportional hazard models, focused on the over 75 group. Results: The 28-day mortality rate was 21.7% (18/83) overall (over 75 group: n = 12 [29.3%]; under 75 group: n = 6 [14.3%]). The areas under the curve (AUCs) of presepsin and iPS-PI for predicting mortality were higher (0.82) in the over 75 group than in the under 75 group. iPS-PI achieved a high AUC (0.82) in the over 75 group with a cutoff value of 2. Furthermore, in a sub-analysis focused on the over 75 group, iPS-PI (Hazard Ratio 14.22, P=0.031) was suggested as a potential independent predictor of mortality, whereas presepsin alone was not (P=0.656). Conclusion: iPS-PI may be superior to presepsin alone as an independent predictor of mortality in extremely elderly sepsis patients. This finding strongly advocates for the use of iPS-PI as a time-sensitive "rule in" tool for early risk stratification, facilitating immediate and tailored aggressive therapeutic interventions by geriatric and critical care clinicians. iPS-PI also directly addresses the diagnostic challenges unique to geriatric sepsis management.
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