N in Fig. 3a. The AUCs (regions beneath the curve) calculated from ROC curves have been 0.75 for Presepsin and 0.80 for PCT, whereas those of SAPS II (0.57) and SOFA (0.64) were reduced (Fig. 3a). When we combined Presepsin and PCT, AUC was at 0.84 (Fig. 3a). At a cutoff value of 466.five pgmL, sensitivity and specificity of Presepsin to serious sepsis and septic shock diagnosis were 90 and 55 , respectively (Table 4). Decrease sensitivity (80 ) and higher specificity (59 ) had been observed for PCT (cutoff value: 0.5 pg mL). The purchase ABT-239 
mixture of Presepsin and PCT drastically improved specificity and PPV (Table 4). The ROC curves were also developed which includes these individuals admitted with ARF showed that the diagnostic value of Presepsin to discriminate infectious (sCAP) and non-infectious respiratory failure (AUC = 0.85) was higher than that of PCT (0.79), SAPS II (0.72), SOFAKlouche et al. Ann. Intensive Care (2016) 6:Page 4 of222 Pa ents admi ed to ICUsjanuary-may78 pa ents excluded:28 for exclusion criteria 20 refused to consent 22 for undetermined diagnosis of sepsis eight for missing dataStudy popula on n =sep c pa ents: n=non sep c pa ents: n=severe sepsis n=sep c shock n=sCAPn=SIRS n=NIRFn=non SIRS n=ARFn=Fig. 1 Flowchart for the study population. SIRS systemic inflammatory systemic response, ARF acute respiratory failure, NIRF non-infectious respiratory failure, sCAP extreme community-acquired pneumoniaTable 1 Patient characteristicsAll patients n = 144 Sex (malefemale) Age, years (imply SD) SAPS II, median (IQR) SOFA, median (IQR) Creatininemia, median (IQR), (molL) hsCRP, median (IQR), (mgL) PCT, median (IQR), (ngmL) Presepsin, median (IQR), (pgmL) ICU length of keep (IQR), (days) ICU mortality, n ( ) In-hospital mortality, n ( )Comparison involving septic and non-septic patients SAPS simplified acute physiology score, SOFA sequential organ failure assessment score, PCT procalcitonin, hsCRP high-sensitivity C-reactive protein p: differences in between septic and non-septic patientsNon-sepsis n = 44 2717 57.5 20.1 44 (270) six (40) 80 (2907) 31 (57) 0.three (0.1.9) 454 (31515) three (1) 9 (20.4) 10 (22.7)Sepsis n = 100 6139 58.three 16 8 (61) 57 (2601) 180 (8184) 4.7 (0.80.5) 1432 (773337) 5 (21) 25 (25) 28 (28) 48 (364)p value ns 0.907 0.176 0.008 0.419 0.0001 0.0001 0.0001 0.04 ns ns8856 58 17.5 eight (61) 68 (2702) 108 (3833) 1.89 (0.323.7) 1058 (510090) four (20) 34 (23.6) 38 (26.three) 47 (332)(0.78) scores, and related to that from the mixture of Presepsin and PCT (0.84) (Fig. 3b). Utilizing a cutoff of Presepsin at 588 pgmL, sensitivity (81 ), specificity(80 ), NPV and PPV values are higher than those of PCT (Table four). The combination of Presepsin and PCT improved specificity, NPV and PPV reaching up to 97 .Klouche PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21301061 et al. Ann. Intensive Care (2016) six:Page five ofTable 2 Causes of infection within the one hundred septic patientsCauses of infection Pneumonia Intra-abdominal infection Meningitidis Urinary infection Isolated bacteremia Other individuals UnknownForty sufferers had a positive blood cultures at ICU admissionn 100 58 11 eight six five 6best cutoff value of Presepsin level to discriminate survivors from non-survivors was at 714 pgmL (p = 0.04) (Fig. 4d).Prognostic value of Presepsin levelsOf the one hundred septic sufferers integrated within the study, 25 (25 ) died through ICU stay. Deceased septic sufferers showed considerably higher Presepsin, PCT levels and severity scores at ICU admission (Table 5). Following thirty ICU days, Kaplan eier curve assessing the influence of Presepsin levels on survival amon.
