Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis

降钙素原 医学 荟萃分析 败血症 科克伦图书馆 内科学 研究异质性 接收机工作特性 人口 生物标志物 重症监护医学 梅德林 感染性休克 法学 化学 环境卫生 生物化学 政治学
作者
Christina Wacker,Anna Prkno,Frank M. Brunkhorst,Peter Schlattmann
出处
期刊:Lancet Infectious Diseases [Elsevier]
卷期号:13 (5): 426-435 被引量:1014
标识
DOI:10.1016/s1473-3099(12)70323-7
摘要

Summary

Background

Procalcitonin is a promising marker for identification of bacterial infections. We assessed the accuracy and clinical value of procalcitonin for diagnosis of sepsis in critically ill patients.

Methods

We searched Medline, Embase, ISI Web of Knowledge, the Cochrane Library, Scopus, BioMed Central, and Science Direct, from inception to Feb 21, 2012, and reference lists of identified primary studies. We included articles written in English, German, or French that investigated procalcitonin for differentiation of septic patients—those with sepsis, severe sepsis, or septic shock—from those with a systemic inflammatory response syndrome of non-infectious origin. Studies of healthy people, patients without probable infection, and children younger than 28 days were excluded. Two independent investigators extracted patient and study characteristics; discrepancies were resolved by consensus. We calculated individual and pooled sensitivities and specificities. We used I2 to test heterogeneity and investigated the source of heterogeneity by metaregression.

Findings

Our search returned 3487 reports, of which 30 fulfilled the inclusion criteria, accounting for 3244 patients. Bivariate analysis yielded a mean sensitivity of 0·77 (95% CI 0·72–0·81) and specificity of 0·79 (95% CI 0·74–0·84). The area under the receiver operating characteristic curve was 0·85 (95% CI 0·81–0·88). The studies had substantial heterogeneity (I2=96%, 95% CI 94–99). None of the subgroups investigated—population, admission category, assay used, severity of disease, and description and masking of the reference standard—could account for the heterogeneity.

Interpretation

Procalcitonin is a helpful biomarker for early diagnosis of sepsis in critically ill patients. Nevertheless, the results of the test must be interpreted carefully in the context of medical history, physical examination, and microbiological assessment.

Funding

Ministry of Education and Research, the Deutsche Forschungsgemeinschaft, Thuringian Ministry for Education, Science and Culture, the Thuringian Foundation for Technology, Innovation and Research, and the German Sepsis Society.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
慕迎蕾发布了新的文献求助10
1秒前
qiu完成签到,获得积分10
2秒前
脑洞疼应助愉快幻悲采纳,获得10
2秒前
Singularity应助ls0911采纳,获得10
2秒前
2秒前
张浩威发布了新的文献求助10
3秒前
小何完成签到,获得积分10
5秒前
积极诗霜发布了新的文献求助10
5秒前
5秒前
9秒前
左友铭发布了新的文献求助10
10秒前
Martin发布了新的文献求助10
11秒前
13秒前
杨婧完成签到,获得积分10
14秒前
YYY发布了新的文献求助10
14秒前
lili发布了新的文献求助10
15秒前
称心饼干完成签到 ,获得积分10
16秒前
16秒前
17秒前
科研通AI2S应助歪歪小正采纳,获得10
18秒前
nicole完成签到,获得积分10
18秒前
桐桐应助大气的莆采纳,获得10
19秒前
19秒前
19秒前
Aliothae完成签到,获得积分10
20秒前
20秒前
21秒前
21秒前
Majician完成签到,获得积分10
21秒前
时尚的明辉完成签到,获得积分10
22秒前
22秒前
23秒前
23秒前
Espresso完成签到,获得积分10
23秒前
李冬完成签到,获得积分10
23秒前
晚湖发布了新的文献求助10
24秒前
天真彩虹完成签到 ,获得积分10
24秒前
ll完成签到,获得积分10
24秒前
李思言发布了新的文献求助10
24秒前
稳重凤凰发布了新的文献求助10
25秒前
高分求助中
The ACS Guide to Scholarly Communication 2500
Sustainability in Tides Chemistry 2000
Microlepidoptera Palaearctica, Volumes 1 and 3 - 13 (12-Volume Set) [German] 1122
Diamonds: Properties, Synthesis and Applications 1000
The Data Economy: Tools and Applications 1000
Mantiden - Faszinierende Lauerjäger – Buch gebraucht kaufen 700
PraxisRatgeber Mantiden., faszinierende Lauerjäger. – Buch gebraucht kaufe 700
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3098628
求助须知:如何正确求助?哪些是违规求助? 2750398
关于积分的说明 7608117
捐赠科研通 2402221
什么是DOI,文献DOI怎么找? 1274557
科研通“疑难数据库(出版商)”最低求助积分说明 616124
版权声明 599033