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Diagnostic accuracy of PCT, IL-6, and MR-ProADM for early identification of sepsis in the emergency department.

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Title: Diagnostic accuracy of PCT, IL-6, and MR-ProADM for early identification of sepsis in the emergency department.
Alternate Title: Precisión diagnóstica de la PCT, la IL-6 y la MR-ProADM para la identificación temprana de la sepsis en el servicio de urgencias.
Authors: Tejada, Sofía1 sofia.tejada@idisba.es, Clemente, Antonio2,3, Socias, Antonia1,4,5, Giglio, Andrés1,4,6,7,8, Aranda, María1,4, del Castillo, Alberto1,4, Mena, Joana1,4, Ribas, Joana María9, Martín, Luisa9, Llerena, Karla Milagritos9, Arellano, María Magdalena9, Agudo, Miguel9, de la Rica, Roberto1,3, Borges, Marcio1,4,5,6 mborges1967@yahoo.es
Source: Revista Española de Quimioterapia. jun2026, Vol. 39 Issue 3, p238-252. 15p.
Subjects: INTERLEUKIN-6, SEPSIS, BIOMARKERS, ADRENOMEDULLIN, SEPTIC shock, EMERGENCY room visits, DIAGNOSIS
Abstract (English): Objective: To evaluate the diagnostic accuracy of the biomarkers procalcitonin (PCT), interleukin-6 (IL-6), and mid-regional pro-adrenomedullin (MR-ProADM), individually and in combination, for early detection of sepsis and septic shock during emergency department (ED) triage. Materials and methods: A retrospective observational study was conducted in adults presenting to the ED with triage levels 2 and 3 between December 2021 and July 2023. Blood samples were collected at admission, prior to any therapeutic intervention. Plasma concentrations of PCT, IL-6, and MR-ProADM were measured using CMIA or ELISA. Diagnostic accuracy was assessed using ROC curves and AUC analysis. Results: A total of 248 patients were included (214 with sepsis and 34 non-septic controls). Simultaneous elevation of PCT, IL-6, and MR-ProADM was observed in 70% of septic patients compared with 3% of controls. Each biomarker showed high diagnostic accuracy for sepsis (AUROC >0.90). The combined assessment increased specificity and was strongly associated with sepsis and septic shock, with progressively higher odds as the number of elevated biomarkers increased. Higher biomarker burden was also associated with indicators of greater clinical severity, including higher SOFA scores and ICU admission. Conclusions: Combined measurement of PCT, IL-6, and MR-ProADM at ED triage, before therapeutic intervention, improves early identification of patients with sepsis and provides relevant information on initial disease severity. This multiplex platform approach may support clinical prioritization and protocol activation in the ED. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivo: Evaluar la precisión diagnóstica de los biomarcadores procalcitonina (PCT), interleucina 6 (IL-6) y proadrenomedulina de región media (MR-ProADM), de forma individual y combinada, para la detección temprana de sepsis y shock séptico durante el triaje en el servicio de urgencias (SU). Materiales y métodos: Se realizó un estudio observacional retrospectivo en adultos que acudieron al SU con niveles de triaje 2 y 3 entre diciembre de 2021 y julio de 2023. Las muestras de sangre se recogieron al ingreso, antes de cualquier intervención terapéutica. Las concentraciones plasmáticas de PCT, IL-6 y MR-ProADM se determinaron mediante CMIA o ELISA. La precisión diagnóstica se evaluó mediante curvas ROC y análisis del AUC. Resultados: Se incluyeron un total de 248 pacientes: 214 con sepsis y 34 controles no sépticos. La elevación simultánea de PCT, IL-6 y MR-ProADM se observó en el 70% de los pacientes sépticos, frente al 3% de los controles. Cada biomarcador mostró una alta precisión diagnóstica para la sepsis (AUROC >0,90). La evaluación combinada aumentó la especificidad y se asoció estrechamente con la sepsis y el shock séptico, con odds progresivamente mayores a medida que aumentaba el número de biomarcadores elevados. Una mayor carga de biomarcadores también se asoció con indicadores de mayor gravedad clínica, incluidos valores más altos en la escala SOFA e ingreso en la UCI. Conclusiones: La medición combinada de PCT, IL-6 y MR-ProADM durante el triaje en el SU, antes de la intervención terapéutica, mejora la identificación temprana de pacientes con sepsis y aporta información relevante sobre la gravedad inicial de la enfermedad. Este enfoque de plataforma multiplex puede apoyar la priorización clínica y la activación de protocolos en el SU. [ABSTRACT FROM AUTHOR]
Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
  Group: Ti
  Data: Diagnostic accuracy of PCT, IL-6, and MR-ProADM for early identification of sepsis in the emergency department.
– Name: TitleAlt
  Label: Alternate Title
  Group: TiAlt
  Data: Precisión diagnóstica de la PCT, la IL-6 y la MR-ProADM para la identificación temprana de la sepsis en el servicio de urgencias.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Tejada%2C+Sofía%22">Tejada, Sofía</searchLink><relatesTo>1</relatesTo><i> sofia.tejada@idisba.es</i><br /><searchLink fieldCode="AR" term="%22Clemente%2C+Antonio%22">Clemente, Antonio</searchLink><relatesTo>2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Socias%2C+Antonia%22">Socias, Antonia</searchLink><relatesTo>1,4,5</relatesTo><br /><searchLink fieldCode="AR" term="%22Giglio%2C+Andrés%22">Giglio, Andrés</searchLink><relatesTo>1,4,6,7,8</relatesTo><br /><searchLink fieldCode="AR" term="%22Aranda%2C+María%22">Aranda, María</searchLink><relatesTo>1,4</relatesTo><br /><searchLink fieldCode="AR" term="%22del+Castillo%2C+Alberto%22">del Castillo, Alberto</searchLink><relatesTo>1,4</relatesTo><br /><searchLink fieldCode="AR" term="%22Mena%2C+Joana%22">Mena, Joana</searchLink><relatesTo>1,4</relatesTo><br /><searchLink fieldCode="AR" term="%22Ribas%2C+Joana+María%22">Ribas, Joana María</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Martín%2C+Luisa%22">Martín, Luisa</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Llerena%2C+Karla+Milagritos%22">Llerena, Karla Milagritos</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Arellano%2C+María+Magdalena%22">Arellano, María Magdalena</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Agudo%2C+Miguel%22">Agudo, Miguel</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22de+la+Rica%2C+Roberto%22">de la Rica, Roberto</searchLink><relatesTo>1,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Borges%2C+Marcio%22">Borges, Marcio</searchLink><relatesTo>1,4,5,6</relatesTo><i> mborges1967@yahoo.es</i>
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  Data: <searchLink fieldCode="JN" term="%22Revista+Española+de+Quimioterapia%22">Revista Española de Quimioterapia</searchLink>. jun2026, Vol. 39 Issue 3, p238-252. 15p.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22INTERLEUKIN-6%22">INTERLEUKIN-6</searchLink><br /><searchLink fieldCode="DE" term="%22SEPSIS%22">SEPSIS</searchLink><br /><searchLink fieldCode="DE" term="%22BIOMARKERS%22">BIOMARKERS</searchLink><br /><searchLink fieldCode="DE" term="%22ADRENOMEDULLIN%22">ADRENOMEDULLIN</searchLink><br /><searchLink fieldCode="DE" term="%22SEPTIC+shock%22">SEPTIC shock</searchLink><br /><searchLink fieldCode="DE" term="%22EMERGENCY+room+visits%22">EMERGENCY room visits</searchLink><br /><searchLink fieldCode="DE" term="%22DIAGNOSIS%22">DIAGNOSIS</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objective: To evaluate the diagnostic accuracy of the biomarkers procalcitonin (PCT), interleukin-6 (IL-6), and mid-regional pro-adrenomedullin (MR-ProADM), individually and in combination, for early detection of sepsis and septic shock during emergency department (ED) triage. Materials and methods: A retrospective observational study was conducted in adults presenting to the ED with triage levels 2 and 3 between December 2021 and July 2023. Blood samples were collected at admission, prior to any therapeutic intervention. Plasma concentrations of PCT, IL-6, and MR-ProADM were measured using CMIA or ELISA. Diagnostic accuracy was assessed using ROC curves and AUC analysis. Results: A total of 248 patients were included (214 with sepsis and 34 non-septic controls). Simultaneous elevation of PCT, IL-6, and MR-ProADM was observed in 70% of septic patients compared with 3% of controls. Each biomarker showed high diagnostic accuracy for sepsis (AUROC >0.90). The combined assessment increased specificity and was strongly associated with sepsis and septic shock, with progressively higher odds as the number of elevated biomarkers increased. Higher biomarker burden was also associated with indicators of greater clinical severity, including higher SOFA scores and ICU admission. Conclusions: Combined measurement of PCT, IL-6, and MR-ProADM at ED triage, before therapeutic intervention, improves early identification of patients with sepsis and provides relevant information on initial disease severity. This multiplex platform approach may support clinical prioritization and protocol activation in the ED. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Objetivo: Evaluar la precisión diagnóstica de los biomarcadores procalcitonina (PCT), interleucina 6 (IL-6) y proadrenomedulina de región media (MR-ProADM), de forma individual y combinada, para la detección temprana de sepsis y shock séptico durante el triaje en el servicio de urgencias (SU). Materiales y métodos: Se realizó un estudio observacional retrospectivo en adultos que acudieron al SU con niveles de triaje 2 y 3 entre diciembre de 2021 y julio de 2023. Las muestras de sangre se recogieron al ingreso, antes de cualquier intervención terapéutica. Las concentraciones plasmáticas de PCT, IL-6 y MR-ProADM se determinaron mediante CMIA o ELISA. La precisión diagnóstica se evaluó mediante curvas ROC y análisis del AUC. Resultados: Se incluyeron un total de 248 pacientes: 214 con sepsis y 34 controles no sépticos. La elevación simultánea de PCT, IL-6 y MR-ProADM se observó en el 70% de los pacientes sépticos, frente al 3% de los controles. Cada biomarcador mostró una alta precisión diagnóstica para la sepsis (AUROC >0,90). La evaluación combinada aumentó la especificidad y se asoció estrechamente con la sepsis y el shock séptico, con odds progresivamente mayores a medida que aumentaba el número de biomarcadores elevados. Una mayor carga de biomarcadores también se asoció con indicadores de mayor gravedad clínica, incluidos valores más altos en la escala SOFA e ingreso en la UCI. Conclusiones: La medición combinada de PCT, IL-6 y MR-ProADM durante el triaje en el SU, antes de la intervención terapéutica, mejora la identificación temprana de pacientes con sepsis y aporta información relevante sobre la gravedad inicial de la enfermedad. Este enfoque de plataforma multiplex puede apoyar la priorización clínica y la activación de protocolos en el SU. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.37201/req/145.2026
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        Text: English
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