Agustin Iskandar, Aryati, Wiwi Jaya, Andrea Aprilia, Salvatore Di Somma
Sepsis remains a global challenge and a leading cause of mortality. Accurate prognostic biomarkers are needed to support risk stratification. Procalcitonin (PCT) and soluble urokinase plasminogen activator receptor (suPAR) are established sepsis biomarkers, but their combined prognostic value remains unclear. This study included 110 patients diagnosed with sepsis based on the 2016 Sepsis-3 criteria. Serum suPAR was measured using Enzyme-linked Immunosorbent Assay, and PCT was measured using Electrochemiluminescence Immunoassay. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox Proportional Hazards models. Non-survivors had higher suPAR, PCT, and SOFA scores than survivors. In continuous-variable Cox regression, log-transformed suPAR and PCT were assessed for 28-day mortality. When added separately to SOFA score, log suPAR (HR 1.135; 95% CI: 1.006–1.281; p = 0.040) and log PCT (HR 1.190; 95% CI: 1.013–1.399; p = 0.035) were significantly associated with mortality. In the combined model, both biomarkers showed borderline associations. Adding suPAR and PCT to SOFA modestly improved discrimination (C-index 0.546 to 0.588; ΔC-index +0.043; LRT p = 0.016), with an optimism-corrected C-index of 0.564. suPAR and PCT showed modest incremental prognostic value beyond SOFA. Combined assessment should be interpreted as exploratory and adjunctive, not as a standalone prognostic tool. © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya/Dr. Saiful Anwar General Hospital, East Java, Malang, Indonesia; Department of Clinical Pathology, Faculty of Medicine Airlangga University/Dr. Soetomo General Hospital, East Java, Surabaya, Indonesia; Department of Anesthesiology and Intensive Care, Faculty of Medicine Universitas Brawijaya/Dr. Saiful Anwar General Hospital, East Java, Malang, Indonesia; Department of Clinical Pathology, School of Medicine and Health, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia; Emergency Medicine, Department of Medical-Surgery Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
