• de Guadiana Romualdo Luis García LG Clinical Chemistry Laboratory, Santa Lucía Hospital, Cartagena, Spain. Electronic address: guadianarom@yahoo.es., Patricia Esteban Torrella, Sergio Rebollo Acebes, Otón María Dolores Albaladejo MDA Clinical Chemistry Laboratory, Santa Lucía Hospital, Cartagena, Spain., Roberto Jiménez Sánchez, Ana Hernando Holgado, Santos Enrique Jiménez EJ Clinical Chemistry Laboratory, Santa Lucía Hospital, Cartagena, Spain., and Alejandro Ortín Freire.
• Clinical Chemistry Laboratory, Santa Lucía Hospital, Cartagena, Spain. Electronic address: guadianarom@yahoo.es.
• Clin. Chim. Acta. 2017 Jan 1; 464: 6-11.

BackgroundPresepsin is a promising biomarker for the diagnosis and prognosis of sepsis. However, results reported about its value to diagnose sepsis in an emergency department (ED) are controversial, probably due to differences in the design of the studies. We have evaluated the diagnostic accuracy of presepsin for infection and sepsis, compared with procalcitonin (PCT) and C-reactive protein (CRP), in patients presenting to the emergency department (ED) with suspected infection.Methods223 patients with suspected infection were enrolled for the study. Blood samples were collected on admission for measurement of biomarkers. Definitive diagnosis was obtained afterwards by analysis of digital medical records. Receiver operating characteristic (ROC) curve analysis was conducted to determine the diagnostic accuracy.ResultsInfection was confirmed in 200 patients, including 130 with non-complicated infection and 70 with sepsis. Median CRP, PCT and presepsin levels were significantly higher in patients with infection and sepsis. PCT was the biomarker with the highest performance for infection (ROC AUC: 0.910); for sepsis, PCT (ROC AUC: 0.815) and presepsin (ROC AUC: 0.775) shown a similar performance.ConclusionAlthough presepsin is a valuable biomarker for diagnosis of infection and sepsis, its diagnostic accuracy in our study does not improve that of PCT. Its introduction in clinical practice is not justified.Copyright © 2016 Elsevier B.V. All rights reserved.

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