Among patients ARQ197 NSCLC with a definitive diagnosis of infection, measurements obtained from monitoring biomarker values at T0 (first medical evaluation in the ED), T1 (24 hours after admission) and T2 (72 hours after admission) showed significant results. Presepsin displayed the highest concentration at T0 compared to T1 and T2, with a significant increasing trend over time (P = 0.0444). The highest PCT concentrations were observed after 24 hours (T1) in comparison to T0 and T2 (P < 0.001) (Figure (Figure11).Diagnostic accuracyThe receiver operating characteristic (ROC) curves were designed including those patients with a definitive diagnosis of sepsis or severe sepsis/septic shock (Figure (Figure2).2). The results were significant for both biomarkers. The areas under the curve (AUCs) calculated from the ROC curve were 0.

701 (95% confidence interval (CI), 0.63 to 0.77; P < 0.001,) for presepsin and 0.875 (95% CI, 0.82 to 0.92; P < 0.001) for PCT, respectively. The difference between the two AUCs was significant (P < 0.001). The best diagnostic cutoff for presepsin was 600 pg/ml. At that level, sensitivity and specificity were 78.95% (95% CI, 69.4 to 86.6) and 61.90% (95% CI, 50.7 to 72.3), respectively. The best diagnostic cutoff in terms of sensitivity and specificity for PCT was 0.18 ng/ml, corresponding to 89.47% sensitivity (range, they actually were 95% CI 81.5% to 94.8%) and 75.90% specificity (range, 65.3% to 84.6%).Figure 2Receiver operating characteristic curve for presepsin (blue) and procalcitonin (green) in patients with definitive diagnosis of sepsis, severe sepsis or septic shock.

Areas under the curve were 0.70 for presepsin (P < 0.001) and 0.87 for procalcitonin ...Prognostic roleSome patients were lost at the time of 60-day follow-up, but data for the remaining group were significant and representative (N = 118). Anacetrapib A Kaplan-Meier graph showed that presepsin values at T0 (first evaluation in the ED) were correlated with 60-day in-hospital mortality in patients with sepsis and severe sepsis or septic shock (Figure (Figure3).3). Mean initial levels were 4,232.4 pg/ml in nonsurvivor patients and 3,451.2 pg/ml in survivor patients (P = 0.04). No significant correlations were observed between presepsin level at T1 or T2 and survival rates. The comparison between PCT levels at T0 in nonsurvivor patients (17.12 ng/ml) and survivors (9.59 ng/ml) did not demonstrate a significant correlation (P = 0.87).Figure 3Kaplan-Meier graph showing correlation between initial values (time 0) of presepsin and survival in patients with sepsis, severe sepsis and septic shock. Sixty-day in-hospital mortality was higher in patients with initial values of presepsin greater than …