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Meta-Analysis
. 2021 Apr 26;21(1):384.
doi: 10.1186/s12879-021-06064-0.

Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: a meta-analysis

Shan Cong  1 , Tiangang Ma  1 , Xin Di  1 , Chang Tian  1 , Min Zhao  1 , Ke Wang  2
Affiliations
Meta-Analysis

Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: a meta-analysis

Shan Cong et al. BMC Infect Dis. .

Abstract

Background: The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) as markers for the diagnosis of sepsis in adult patients.

Methods: Various databases were searched to collect published studies on the diagnosis of sepsis in adult patients using neutrophil CD64, PCT, and IL-6 levels. Utilizing the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated.

Results: Fifty-four articles were included in the study. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 (95% confidence interval [CI], 0.81-0.92), 0.88 (95% CI, 0.83-0.91), and 0.94 (95% CI, 0.91-0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78-0.85), 0.78 (95% CI, 0.74-0.82), and 0.87 (95% CI, 0.83-0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83-0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78-0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65-0.78), 0.70 (95% CI, 0.62-0.76), and 0.77 (95% CI, 0.73-0.80), respectively.

Conclusions: Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic potential for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.

Keywords: Interleukin-6; Meta-analysis; Neutrophil CD64; Procalcitonin; Sepsis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the search strategy and study selection process
Fig. 2
Fig. 2
a Risk of bias. b Clinical applicability
Fig. 3
Fig. 3
Summary receiver operator characteristic (SROC) of CD64 (a) across 20 studies, PCT (b) across 43 studies, and IL-6 (c) across 16 studies
Fig. 4
Fig. 4
Forest plots of the sensitivity and specificity for CD64 with a 95% confidence interval on the 20 included studies
Fig. 5
Fig. 5
Forest plots of the sensitivity and specificity for PCT with a 95% confidence interval on the 43 included studies
Fig. 6
Fig. 6
Forest plots of the sensitivity and specificity for IL-6 with a 95% confidence interval on the 16 included studies
Fig. 7
Fig. 7
Deeks’ funnel figure for the assessment of potential publication bias for neutrophil CD64 (a), PCT (b), and IL-6 (c) expression in the diagnosis of sepsis
Fig. 8
Fig. 8
Meta-regression for neutrophil CD64 (a), PCT (b), and IL-6 (c) expression in the diagnosis of sepsis. Meta-regression was performed according to whether the sample size of the study was over 100, study subjects were Chinese, the average age of the study population was over 65, and the clinical setting was classified into ICU and measuring methods
Fig. 9
Fig. 9
Sensitivity analysis for neutrophil CD64 (a), PCT (b), and IL-6 (c) expression in the diagnosis of sepsis
Fig. 10
Fig. 10
Fagan’s nomogram for neutrophil CD64 (a), PCT (b), and IL-6 (c) expression in the diagnosis of sepsis
See this image and copyright information in PMC

References

    1. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, Colombara DV, Ikuta KS, Kissoon N, Finfer S, Fleischmann-Struzek C, Machado FR, Reinhart KK, Rowan K, Seymour CW, Watson RS, West TE, Marinho F, Hay SI, Lozano R, Lopez AD, Angus DC, Murray CJL, Naghavi M. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211. doi: 10.1016/S0140-6736(19)32989-7. - DOI - PMC - PubMed
    1. Verdonk F, Blet A, Mebazaa A. The new sepsis definition: limitations and contribution to research and diagnosis of sepsis. Curr Opin Anaesthesiol. 2017;30(2):200–204. doi: 10.1097/aco.0000000000000446. - DOI - PubMed
    1. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G. 2001 SCCM/ESICM/ACCP/ATS/SIS international Sepsis definitions conference. Crit Care Med. 2003;31(4):1250–1256. doi: 10.1097/01.Ccm.0000050454.01978.3b. - DOI - PubMed
    1. Marik PE, Taeb AM. SIRS, qSOFA and new sepsis definition. J Thorac Dis. 2017;9(4):943–945. doi: 10.21037/jtd.2017.03.125. - DOI - PMC - PubMed
    1. Williams JM, Greenslade JH, McKenzie JV, Chu K, Brown AFT, Lipman J. Systemic inflammatory response syndrome, quick sequential organ function assessment, and organ dysfunction insights from a prospective database of ed patients with infection. Chest. 2017;151(3):586–596. doi: 10.1016/j.chest.2016.10.057. - DOI - PubMed

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