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Meta-Analysis
. 2024 Jan 22;13(1):37.
doi: 10.1186/s13643-023-02432-w.

Accuracy of procalcitonin for diagnosing sepsis in adult patients admitted to the emergency department: a systematic review and meta-analysis

Hany A Zaki  1 , Soumaya Bensliman  1 , Khalid Bashir  1   2 , Haris Iftikhar  1 , Mohamed H Fayed  1 , Waleed Salem  1 , Amr Elmoheen  1   2 , Yavuz Yigit  3   4
Affiliations
Meta-Analysis

Accuracy of procalcitonin for diagnosing sepsis in adult patients admitted to the emergency department: a systematic review and meta-analysis

Hany A Zaki et al. Syst Rev. .

Abstract

Background: Differentiating sepsis from non-infectious systemic inflammatory response syndrome (SIRS) is challenging. Biomarkers like procalcitonin (PCT) aid early risk assessment and guide antibiotic use. This study aims to ascertain PCT's accuracy as a sepsis biomarker among adult emergency department admissions.

Method: The PRISMA guidelines were followed to search for relevant articles in five electronic databases between April 14th and August 4th, 2023: PubMed, Cochrane Library, ProQuest, EMBASEs, and ScienceDirect. Studies had to be published in English to avoid directly translating scientific terms. Besides, the inclusion criteria were based on the diagnosis of sepsis in adult patients admitted to an emergency department. QUADAS-2 tool provided by the Review Manager version 5.4.1 was utilized to assess the risk of bias in included studies. STATA (v. 16) software was used to perform the meta-analysis.

Results: Ten of 2457 studies were included. We sampled 2980 adult sepsis patients for the under-investigated role of PCT in ED sepsis diagnosis. PCT emerged as the primary early diagnostic biomarker with high levels (29.3 ± 85.3 ng/mL) in sepsis patients. Heterogeneity in outcomes, possibly due to bias in cohort and observational studies, was observed.

Conclusion: PCT tests offer moderate accuracy in diagnosing sepsis and stand out for rapidly and precisely distinguishing between viral and bacterial inflammations.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart detailing the search strategy
Fig. 2
Fig. 2
QUADAS-2 Risk of bias and applicability concerns summary: review authors’ judgments about each risk of bias item presented as percentages across all included studies
Fig. 3
Fig. 3
Sensitivity of PCT in sepsis diagnosis
Fig. 4
Fig. 4
Specificity of PCT in sepsis diagnosis
Fig. 5
Fig. 5
PCT's diagnostic odds ratio
Fig. 6
Fig. 6
PCT's positive predictive value in sepsis diagnosis
Fig. 7
Fig. 7
PCT’s negative predictive value in sepsis diagnosis
See this image and copyright information in PMC

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