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Meta-Analysis
. 2023 Feb 22;18(2):e0281897.
doi: 10.1371/journal.pone.0281897. eCollection 2023.

Serum creatinine in predicting mortality after paraquat poisoning: A systematic review and meta-analysis

Wei Huang  1   2 , Zheng Zhang  1   2 , Yuan-Qiang Lu  1   2
Affiliations
Meta-Analysis

Serum creatinine in predicting mortality after paraquat poisoning: A systematic review and meta-analysis

Wei Huang et al. PLoS One. .

Abstract

Although the prognostic value of blood creatinine levels in patients with paraquat (PQ) poisoning has been studied for a long time, the results are still controversial. Therefore, we performed the first meta-analysis to comprehensively assess the value of blood creatinine in predicting the prognosis of patients with PQ poisoning. We searched PubMed, EMBase, Web of Science, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and China Online Journals to identify all relevant papers published up to June 2022. Data were extracted for pooled analysis, heterogeneity testing, sensitivity analysis, publication bias analysis, and subgroup analysis. Ultimately, 10 studies involving 862 patients were included. The I2 of diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of this study were all greater than 50%, which showed the existence of heterogeneity in this study, and a random effects model was used for the combination of the above five effect sizes. Pooled analysis showed a high predictive value of blood creatinine for prognosis of PQ poisoning [pooled DOR:22.92, 95% confidence interval (CI):15.62-33.65, P < 0.001]. The combined sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 86% (95% CI: 0.79-0.91), 78% (95% CI: 0.69-0.86), 4.01 (95% CI: 2.81-5.71), and 0.17 (95% CI: 0.12-0.25), respectively. Deeks publication bias test revealed there was publication bias. Sensitivity analysis showed no significant differences in the estimates of impact. Serum creatinine is an effective predictor of mortality in patients with PQ poisoning.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of search process.
Fig 2
Fig 2. Risk of bias and applicability concerns.
(+) denotes low risk, (−) denotes high risk.
Fig 3
Fig 3. Summary ROC curve for the 6 included studies.
Numbers in brackets are 95% CIs. ROC: receiver operating characteristic, AUC: area under curve, SENS: sensitivity, SPEC: specificity, CI: confidence interval.
Fig 4
Fig 4. Forest plot for the association of serum creatinine and mortality of paraquat poisoning.
Fig 5
Fig 5. Forest plots of sensitivity and specificity of Serum creatinine in predicting mortality after paraquat poisoning.
The diamond indicates the combined estimate from the included studies.
Fig 6
Fig 6. Deeks publication bias test.
Fig 7
Fig 7. Sensitivity analysis of the relationship between serum creatinine and mortality of paraquat poisoning.
See this image and copyright information in PMC

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