Meta-analysis Of The Value Of The Procalcitonin Test For The Diagnosis Of Sepsis

Objective:To evaluate the value of the procalcitonin (PCT) test for diagnosing sepsis.Methods:A search in Cochrane Library, PubMed, Ovid, Spring, China National Knowledge Infrastructure (CNKI), Wanfang Chinese Periodical Database and Chinese Bio-medicine Database(CBM)was performed to identify relevant articles from Januanary 1990 to October 2010. The language of the researches was restricted to Chinese and English. ALL English articles were translated into Chinese to assess. Inclusion criteria were established based on validity criteria for diagnostic for diagnostic research. Subsequently, the characteristics of the included articles including study background, design information and diagnostic parameters were extracted. Statistical analysis was performed by employing Meta-DiScl.4 and RevMan5.0 software. Heterogeneity of the included articles was tested for selecting proper effect model to calculate pooled weighted sensitivity, specificity and 95%CI. Summary receiver operating characteristic (SROC) curve was made and the area under the curve (AUC) and Q* index was calculated. Finally, sensitivity analysis and comparison of sensitivity among different groups were performed.Results:We searched 465 relevant English articles,64 Chinese articles. Twelve articles(9 English articles,3 Chinese articles) were included, with total 1080 patients. Tewlve articles meeting inclusion criteria were analyszed for the value of serum PCT levels for the diagnosis of sepsis, the pooled sensitivity, specificity and SROC AUC were 83%,78%和0.9203. Significant heterogeneity among studies was observed. Sensitivity ananlysis showed that differences in PCT assay producer and PCT cutoff, study countries and severity of sepsis in the study population may partially explain the between-studies heterogeneity.Conclusions:The PCT test showed good accuracy in diagnosing sepsis, regardless of differences in diagnostic criteria or time points for testing. PCT should be combined with other diagnostic markers to further improve the sensitivity and accuracy in the diagnosis of sepsis.