Diagnostic performance of procalcitonin and presepsin in sepsis: a systematic review and meta-analysis
Dublin Core
Title
Diagnostic performance of procalcitonin and presepsin in sepsis: a systematic review and meta-analysis
Subject
Sepsis, Procalcitonin, Presepsin, Sensitivity, Specificity, Diagnostic test
Description
Background Sepsis is a critical emergency condition characterized by life-threatening organ dysfunction due to a
dysregulated response to infection. In the fast-paced emergency department (ED) setting, rapid identification and
prompt initiation of treatment within the initial hours following sepsis onset are critical for reducing mortality and
improving patient outcomes. However, a timely and accurate diagnosis remains a significant challenge in emergency
medicine. Biomarkers such as procalcitonin (PCT) and presepsin (P-SEP) have been proposed as tools to distinguish
sepsis from other non-infectious inflammatory conditions frequently encountered in the ED, though their diagnostic
effectiveness remains controversial. This study aimed to evaluate the diagnostic performance of PCT and P-SEP for
diagnosis patients with sepsis.
Methods A comprehensive systematic search was conducted across the Cochrane Central Register of Controlled
Trials, PubMed, and Scopus databases up to April 1st, 2024 and updated on June 30th, 2025. Studies reporting
sensitivity and specificity of PCT and P-SEP for sepsis detection among patients in acute and emergency settings were
included. Hierarchical modeling techniques were utilized to pool data for sensitivity, specificity, and area under the
receiver operating characteristic curve (AUROC) along with their 95% confidence intervals (CIs).
Results Thirty-eight observational studies met inclusion criteria. The pooled sensitivities and specificities for
detecting sepsis using PCT were 0.78 (95% CI: 0.74–0.81) and 0.77 (95% CI: 0.71–0.82), respectively. Similarly, for
P-SEP, pooled sensitivity and specificity were 0.82 (95% CI: 0.77–0.86) and 0.78 (95% CI: 0.73–0.83), respectively. No
statistically significant differences were identified between PCT and P-SEP regarding sensitivity (p=0.169) or specificity
(p=0.792). The summary receiver operating characteristic analysis yielded an AUROC of 0.84 (95% CI: 0.81–0.87) for
PCT and 0.87 (95% CI: 0.84–0.90) for P-SEP.
Conclusions Both PCT and P-SEP represent reliable biomarkers for early and accurate sepsis detection in acute
and ED settings, demonstrating comparable diagnostic performance. Their integration into routine ED assessment
protocols may support timely clinical decision-making and prompt initiation of appropriate treatment strategies.
dysregulated response to infection. In the fast-paced emergency department (ED) setting, rapid identification and
prompt initiation of treatment within the initial hours following sepsis onset are critical for reducing mortality and
improving patient outcomes. However, a timely and accurate diagnosis remains a significant challenge in emergency
medicine. Biomarkers such as procalcitonin (PCT) and presepsin (P-SEP) have been proposed as tools to distinguish
sepsis from other non-infectious inflammatory conditions frequently encountered in the ED, though their diagnostic
effectiveness remains controversial. This study aimed to evaluate the diagnostic performance of PCT and P-SEP for
diagnosis patients with sepsis.
Methods A comprehensive systematic search was conducted across the Cochrane Central Register of Controlled
Trials, PubMed, and Scopus databases up to April 1st, 2024 and updated on June 30th, 2025. Studies reporting
sensitivity and specificity of PCT and P-SEP for sepsis detection among patients in acute and emergency settings were
included. Hierarchical modeling techniques were utilized to pool data for sensitivity, specificity, and area under the
receiver operating characteristic curve (AUROC) along with their 95% confidence intervals (CIs).
Results Thirty-eight observational studies met inclusion criteria. The pooled sensitivities and specificities for
detecting sepsis using PCT were 0.78 (95% CI: 0.74–0.81) and 0.77 (95% CI: 0.71–0.82), respectively. Similarly, for
P-SEP, pooled sensitivity and specificity were 0.82 (95% CI: 0.77–0.86) and 0.78 (95% CI: 0.73–0.83), respectively. No
statistically significant differences were identified between PCT and P-SEP regarding sensitivity (p=0.169) or specificity
(p=0.792). The summary receiver operating characteristic analysis yielded an AUROC of 0.84 (95% CI: 0.81–0.87) for
PCT and 0.87 (95% CI: 0.84–0.90) for P-SEP.
Conclusions Both PCT and P-SEP represent reliable biomarkers for early and accurate sepsis detection in acute
and ED settings, demonstrating comparable diagnostic performance. Their integration into routine ED assessment
protocols may support timely clinical decision-making and prompt initiation of appropriate treatment strategies.
Creator
Tanakon Chairaj1†, Pajaree Mongkhon2†, Pit Leewongsakorn1
, Kritsada Saensongkwae1
, Sawitree Nangola3
,
Somphot Saoin3
, Eakkapote Prompunt3
, Prawat Chantharit4
and Chiraphat Kloypan1*
, Kritsada Saensongkwae1
, Sawitree Nangola3
,
Somphot Saoin3
, Eakkapote Prompunt3
, Prawat Chantharit4
and Chiraphat Kloypan1*
Source
https://doi.org/10.1186/s12873-025-01433-3
Date
2026
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Tanakon Chairaj1†, Pajaree Mongkhon2†, Pit Leewongsakorn1
, Kritsada Saensongkwae1
, Sawitree Nangola3
,
Somphot Saoin3
, Eakkapote Prompunt3
, Prawat Chantharit4
and Chiraphat Kloypan1*, “Diagnostic performance of procalcitonin and presepsin in sepsis: a systematic review and meta-analysis,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12029.