Is Pleural Fluid Presepsin a Reliable Diagnostic Biomarker for Pleural Effusions?

Background/Objectives: Biochemical markers used in the diagnostic evaluation of pleural effusions are limited in both number and diagnostic accuracy. Presepsin has shown promise in bacterial infections. This study aimed to evaluate the diagnostic utility of pleural fluid presepsin for differentiating transudative from exudative pleural effusions.

Methods

In this prospective observational study, presepsin concentrations were measured in pleural fluid obtained during diagnostic thoracentesis. Patients were classified according to Light’s criteria and final clinical diagnosis. Receiver operating characteristic (ROC) analysis was performed to assess diagnostic performance, while multivariable logistic regression identified independent predictors of exudative pleural effusions. Associations between presepsin concentrations and mortality, infectious etiology, and pleural fluid culture positivity were also analyzed.