{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:07:47Z","timestamp":1784887667596,"version":"3.55.0"},"reference-count":28,"publisher":"BMJ","issue":"6","funder":[{"name":"Navamindradhiraj University Research Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Emerg Med J"],"accepted":{"date-parts":[[2025,12,7]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the diagnostic accuracy of presepsin and procalcitonin (PCT) for sepsis and septic shock (Sepsis-3) in the emergency department (ED) based on the Sepsis-3 definition, where early diagnosis remains challenging due to the lack of rapid and reliable diagnostic methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre prospective cohort study recruited adults from eight EDs in Thailand between October 2020 and June 2022. Patients with suspected infection or those who met the quick Sequential Organ Failure Assessment criteria were enrolled. Admission blood samples were analysed for presepsin, PCT, lactate and blood culture, with follow-up presepsin and PCT measurements performed on days 3 and 7, and follow-up for 30-day mortality. Sepsis diagnosis was adjudicated with reference to the Sepsis-3 criteria and blood culture result. Diagnostic accuracy metrics, including the area under the receiver operating characteristics curve (AUROCs), sensitivity, specificity and predictive values of presepsin and PCT were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 668 included participants, 438 (65.6%) were diagnosed with sepsis and 58 (8.7%) with septic shock. Presepsin levels were significantly higher in patients with Sepsis-3 than in patients without sepsis at ED admission and decreased over time. Presepsin exhibited a slightly higher AUROC for predicting sepsis (AUROC 0.63 (95% CI 0.59 to 0.67)) and septic shock (AUROC 0.73 (95% CI 0.66 to 0.80)) compared with PCT (AUROC for sepsis 0.62, 95%\u2009CI 0.58 to 0.66 and septic shock 0.72, 95%\u2009CI 0.65 to 0.78). Elevated presepsin and PCT levels were associated with increased mortality within 30 days (OR 2.61, 95%\u2009CI 1.73 to 3.92 and OR of 1.62, 95%\u2009CI 1.09 to 2.42 consequently).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Presepsin showed slightly higher diagnostic accuracy than PCT, but overall diagnostic accuracy was modest. When interpreted together with clinical assessment and routine tests, presepsin may assist early risk stratification and support, rather than replace, clinical judgement in decisions such as resuscitation or antibiotic initiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/emermed-2025-215345","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T18:20:16Z","timestamp":1767378016000},"page":"360-366","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Presepsin for sepsis diagnosis in emergency departments: a multicentre study"],"prefix":"10.1136","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8853-2567","authenticated-orcid":false,"given":"Jiraporn","family":"Sri-on","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand"},{"name":"Thai College of Emergency Physicians, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6057-256X","authenticated-orcid":false,"given":"Kiattichai","family":"Daorattanachai","sequence":"additional","affiliation":[{"name":"Thai College of Emergency Physicians, Bangkok, Thailand"},{"name":"Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittiyaporn","family":"Wiwatcharagoses","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pariwat","family":"Phungoen","sequence":"additional","affiliation":[{"name":"Thai College of Emergency Physicians, Bangkok, Thailand"},{"name":"Department of Emergency Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suramath","family":"Isaranuwatchai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, King Mongkut\u2019s Institute of Technology Ladkrabang Lat Krabang, Bangkok, Thailand"},{"name":"Division of Nephrology, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2250-6980","authenticated-orcid":false,"given":"Pitsucha","family":"Sanguanwit","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thammapad","family":"Piyasuwankul","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisarut","family":"Bunchit","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natchapon","family":"Sinsuwan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapeeporn","family":"Rojsaengroeng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korakot","family":"Apiratwarakul","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipa","family":"Udonjarut","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parima","family":"Voharnsuchon","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuenruthai","family":"Angkoontassaneeyarat","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Premruedee","family":"Dansuebsakun","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3465-5534","authenticated-orcid":false,"given":"Borwon","family":"Wittayachamnankul","sequence":"additional","affiliation":[{"name":"Thai College of Emergency Physicians, Bangkok, Thailand"},{"name":"Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"},{"name":"Strategy to Achieve Emergency Medicine Research Network in Thailand (START) Working Group, Chiang Mai, Thailand"},{"name":"Acute Care and Emergency Medicine Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"2026071504400824000_43.6.360.1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170149"},{"key":"2026071504400824000_43.6.360.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0289"},{"key":"2026071504400824000_43.6.360.3","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"2026071504400824000_43.6.360.4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201604-0854OC"},{"key":"2026071504400824000_43.6.360.5","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/j.ajem.2017.12.038","article-title":"The utility of presepsin in diagnosis and risk stratification for the emergency patients with sepsis","volume":"36","author":"Lu","year":"2018","journal-title":"Am J Emerg 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Care"},{"key":"2026071504400824000_43.6.360.9","doi-asserted-by":"crossref","DOI":"10.1186\/s40560-019-0407-z","article-title":"Early management of sepsis in medical patients in rural Thailand: a single-center prospective observational study","volume":"7","author":"Rudd","year":"2019","journal-title":"J Intensive Care"},{"key":"2026071504400824000_43.6.360.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-041022","article-title":"Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)","volume":"11","author":"Booraphun","year":"2021","journal-title":"BMJ Open"},{"key":"2026071504400824000_43.6.360.11","doi-asserted-by":"crossref","DOI":"10.1186\/s13049-017-0436-3","article-title":"The most commonly used disease severity scores are inappropriate for risk stratification of older emergency department sepsis patients: an observational multi-centre study","volume":"25","author":"de Groot","year":"2017","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2026071504400824000_43.6.360.12","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1590\/S1679-45082015AO3313","article-title":"Comparative analysis of survival between elderly and non-elderly severe sepsis and septic shock resuscitated patients","volume":"13","author":"Palomba","year":"2015","journal-title":"Einstein (Sao Paulo)"},{"key":"2026071504400824000_43.6.360.13","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1002\/ams2.397","article-title":"An evaluation of clinical inflammatory and coagulation markers in patients with sepsis: a pilot study","volume":"6","author":"Fujii","year":"2019","journal-title":"Acute Med Surg"},{"key":"2026071504400824000_43.6.360.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.04.008"},{"key":"2026071504400824000_43.6.360.15","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.ajem.2017.01.037","article-title":"Evaluating the value of dynamic procalcitonin and presepsin measurements for patients with severe sepsis","volume":"35","author":"Yu","year":"2017","journal-title":"Am J Emerg Med"},{"key":"2026071504400824000_43.6.360.16","doi-asserted-by":"crossref","DOI":"10.1186\/s13613-016-0160-6","article-title":"Diagnostic and prognostic value of soluble CD14 subtype (Presepsin) for sepsis and community-acquired pneumonia in ICU patients","volume":"6","author":"Klouche","year":"2016","journal-title":"Ann Intensive Care"},{"key":"2026071504400824000_43.6.360.17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.cca.2016.11.003","article-title":"Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department","volume":"464","author":"de Guadiana Romualdo","year":"2017","journal-title":"Clinica Chimica 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Presepsin: methods of measure, features and biomarker potential in sepsis and critical care. rajendram r, preedy vr, patel vb. In: Biomarkers in Trauma, Injury and Critical Care [Internet]. Cham: Springer International Publishing, 2023: 691\u2013707. 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