02 software (Analyse-it Software, Ltd, Leeds, UK) for Microsoft Excel (Microsoft, Redmond, WA, USA).ResultsPatient characteristicsA total of 189 patients were included in the study. Eighty-three of them presented with SIRS due to acute medical Bosutinib order conditions or trauma and were enrolled in the control group. Fifty-five patients were diagnosed with sepsis, and fifty-one had severe sepsis or septic shock. Demographic characteristics and mean SOFA and APACHE II scores at presentation are reported in Table Table11.Diagnostic roleThe mean presepsin concentrations in plasma were 2,516.4 pg/ml in the control group, 2,866.7 pg/ml (range, 1,579 to 4,154) in patients affected by sepsis and 3,167.1 pg/ml in the severe sepsis and septic shock group.

Mean levels of PCT in controls, sepsis and severe sepsis and septic shock patients were 1 ng/ml, 9 ng/ml and 19 ng/ml, respectively. Median values for presepsin were 517 pg/ml in controls, 875 pg/ml in septic patients and 1,460 pg/ml in patients with severe sepsis or septic shock (Figure (Figure1).1). Presepsin initial values (T0) were significantly different between controls and the sepsis group (P = 0.002) and between controls and the severe sepsis and septic shock group (P < 0.001), whereas no significant difference was noted between the sepsis and severe sepsis/septic shock groups (P = 0.07). PCT values at presentation (T0) were conversely significantly different between all three groups (Table (Table33).Figure 1Median (boxplots) values of presepsin and procalcitonin in controls and in sepsis and severe sepsis/septic shock patient populations at time 0.

95% confidence intervals (CIs) are reported. Median (boxplots) seriated values of presepsin and procalcitonin …Table 3Mean values and (95% confidence intervals) of presepsin and procalcitonin in the three populations.aBoth presepsin and PCT concentrations were significantly lower in all nonseptic SIRS patients (acute pancreatitis, aortic dissection, pulmonary embolism, acute coronary syndrome, multiple trauma and burns) in comparison to patients with sepsis, severe sepsis or septic shock. Presepsin levels at T0 significantly correlated with PCT levels at T0 (P = 0.001) and with SOFA score (P = 0.008). PCT levels at the time of the first medical evaluation in the ED were significantly correlated with high values of serum lactate (P = 0.004).

Presepsin and PCT initial values (T0) did not differ significantly according to the primary sites of infection (urinary tract, lung, abdomen, skin, central venous device-related, central nervous system (CNS) and oral infection) among patients with a confirmed diagnosis of sepsis, severe sepsis or septic shock when the starting focus could be identified (Table (Table44).Table Carfilzomib 4Biomarkers blood levels according to primary sites of infections in patients with diagnosis of infection (sepsis, severe sepsis or septic shock) at time 0.