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Wu CC, Lan HM, Han ST, et al. Comparison of diagnostic accuracy in sepsis between presepsin, procalcitonin, and C-reactive protein: a systematic review and meta-analysis. Ann Intensive Care. 2017;7(1):91doi: 10.1186/s13613-017-0316-z.
Wu, C. C., Lan, H. M., Han, S. T., Chaou, C. H., Yeh, C. F., Liu, S. H., Li, C. H., Blaney, G. N., Liu, Z. Y., & Chen, K. F. (2017). Comparison of diagnostic accuracy in sepsis between presepsin, procalcitonin, and C-reactive protein: a systematic review and meta-analysis. Annals of intensive care, 7(1), 91. https://doi.org/10.1186/s13613-017-0316-z
Wu, Chin-Chieh, et al. "Comparison of diagnostic accuracy in sepsis between presepsin, procalcitonin, and C-reactive protein: a systematic review and meta-analysis." Annals of intensive care vol. 7,1 (2017): 91. doi: https://doi.org/10.1186/s13613-017-0316-z
Wu CC, Lan HM, Han ST, Chaou CH, Yeh CF, Liu SH, Li CH, Blaney GN, Liu ZY, Chen KF. Comparison of diagnostic accuracy in sepsis between presepsin, procalcitonin, and C-reactive protein: a systematic review and meta-analysis. Ann Intensive Care. 2017 Sep 06;7(1):91. doi: 10.1186/s13613-017-0316-z. PMID: 28875483; PMCID: PMC5585118.
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Ann Intensive Care. 2017 Sep 06;7(1):91. doi: 10.1186/s13613-017-0316-z.

Comparison of diagnostic accuracy in sepsis between presepsin, procalcitonin, and C-reactive protein: a systematic review and meta-analysis.

Annals of intensive care

Chin-Chieh Wu, Hao-Min Lan, Shih-Tsung Han, Chung-Hsien Chaou, Chun-Fu Yeh, Su-Hsun Liu, Chih-Huang Li, Gerald N Blaney, Zhen-Ying Liu, Kuan-Fu Chen

Affiliations

  1. Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
  2. School of Medicine, Chang Gung University, Taoyuan, Taiwan.
  3. Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
  4. Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
  5. Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
  6. Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan. [email protected].
  7. Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan. [email protected].
  8. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, 5 Fu-Shin Street, Gueishan Village, Taoyuan, 333, Taiwan. [email protected].
  9. Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan. [email protected].

PMID: 28875483 PMCID: PMC5585118 DOI: 10.1186/s13613-017-0316-z

Abstract

BACKGROUND: The soluble cluster of differentiation 14 (or presepsin) is a free fragment of glycoprotein expressed on monocytes and macrophages. Although many studies have been conducted recently, the diagnostic performance of presepsin for sepsis remains debated. We performed a systematic review and meta-analysis of the available literature to assess the accuracy of presepsin for the diagnosis of sepsis in adult patients and compared the performance between presepsin, C-reactive protein (CRP), and procalcitonin (PCT).

METHODS: A comprehensive systemic search was conducted in PubMed, EMBASE, and Google Scholar for studies that evaluated the diagnostic accuracy of presepsin for sepsis until January 2017. The hierarchical summary receiver operating characteristic method was used to pool individual sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the receiver operating characteristic curve (AUC).

RESULTS: Eighteen studies, comprising 3470 patients, met our inclusion criteria. The pooled diagnosis sensitivity and specificity of presepsin for sepsis were 0.84 (95% CI 0.80-0.87) and 0.76 (95% CI 0.67-0.82), respectively. Furthermore, the pooled DOR, PLR, NLR, and AUC were 16 (95% CI 10-25), 3.4 (95% CI 2.5-4.6), 0.22 (95% CI 0.17-0.27), and 0.88 (95% CI 0.85-0.90), respectively. Significant heterogeneity was found in both sensitivities (Cochrane Q = 137.43, p < 0.001, I

CONCLUSION: Based on the results of our meta-analysis, presepsin is a promising marker for diagnosis of sepsis as PCT or CRP, but its results should be interpreted more carefully and cautiously since too few studies were included and those studies had high heterogeneity between them. In addition, continuing re-evaluation during the course of sepsis is advisable.

Keywords: Adults; Meta-analysis; Presepsin; Sensitivity; Sepsis; Specificity; sCD14

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