Value of procalcitonin and presepsin in the diagnosis and severity stratification of sepsis and septic shock.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.[1,2]Septic shock,the most severe form of sepsis,is characterized by circulatory and cellular/metabolic abnormalities,and can increase mortality to＞40％.[1-3]Early recognition and risk stratification of septic shock are crucial but challenging because of the heterogeneity of its presentation and progression.Although blood culture is recognized as the gold standard for detecting sepsis,it usually takes several days to obtain result,which may delay the diagnosis.Therefore,with the advantage of rapid screening of pathogens,bedside biomarker detection has been widely used for identifying high-risk patients.Procalcitonin(PCT),C-reactive protein(CRP)and presepsin are the most commonly used biomarkers for sepsis.[4]However,there has been no research comparing the predictive value of presepsin,PCT and CRP for septic shock and risk stratification.Therefore,this study aimed to compare the accuracy of presepsin,PCT and CRP in identifying septic shock and assessing organ dysfunction in a large sample of septic patients.