Examinando por Autor "Borges, Marcio"

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    Comment on: Is “pre-sepsis” the new sepsis? A narrative review
    (Public Library of Science, 0006-03-26) Giglio, Andrés; Aranda, mario; Macias, Eric; Borges, Marcio
    El presente comentario al editor presenta la experiencia clínica con BiAlert Sepsis AI en un hospital, aportando evidencia al concepto de pre-sepsis propuesto por Gerard et al.. Los datos muestran que la mayoría de los pacientes detectados por la IA son infectados sin disfunción orgánica temprana y permiten definir cuatro trayectorias clínicas dentro de la pre-sepsis: pacientes en riesgo que no desarrollan sepsis, evolución abortada, sepsis subumbral y pre-sepsis progresiva con desarrollo de sepsis en 24–48 horas. Estas trayectorias evidencian que la sepsis debe entenderse como un continuo más que como un punto de corte binario y respaldan la necesidad de enfoques diagnósticos y terapéuticos basados en trayectorias para intervenir precozmente en esta ventana crítica.
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    Diagnostic accuracy of PCT, IL-6, and MR-ProADM for early identification of sepsis in the emergency department
    (Sociedad Española de Quimioterapia, 2026-05-29) Tejada, Sofía; Clemente, Antonio; Socias, Antonia; Giglio, Andrés; Aranda, María; del Castillo, Alberto; Mena, Joana; Ribas, Joana María; Martín, Luisa; Llerena, Karla Milagritos; Arellano, María Magdalena; Agudo, Miguel; de la Rica, Roberto; Borges, Marcio
    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.