Diagnostic Value Of Procalcitonin For Detection Of Serious Bacterial Infections In Children Having Different Thermal Process:a Systematic Review

Objective:To conduct a systematic review to identify the diagnostic value of procalcitonin (PCT) for detecting serious bacterial infections in children have different thermal process. Methods:A comprehensive electronic search was performed to retrieve relevant studies on PCT in diagnosis of serious bacterial infections in children. From the initiation of the database from establishment to July 2014, QUADAS items were used to evaluate the quality of included studies. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, summary receiver operating characteristic curve (SROC), and the heterogeneity of included studies with different thermal process were analyzed by using the Meta-Disk1.4 software. Finally, the sensitivity and analysis for heterogeneity cause were performed and Stata 12.0 software was used to assess the publication bias with funnel plot. Result:Eleven studies were included for the review, including 10 English studies,1 Chinese study. The pooled sensitivity and specificity of PCT test for thermal process under 24 h were 0.75 and 0.80, SROC area under the curve (AUC) was 0.870; the pooled sensitivity and specificity of WBC were 0.48 and 0.54, AUC was 0.484; sensitivity and specificity of ANC were 0.30 and 0.78, respectively. The pooled sensitivity and specificity of PCT test for thermal process between 24 and 48 h were 0.86 and 0.63, AUC was 0.857; the pooled sensitivity and specificity of WBC were 0.54,0.46, AUC was 0.558; sensitivity and specificity of ANC were 0.47 and 0.12, respectively. The pooled sensitivity and specificity of PCT test for thermal process over 48 h were 0.83 and 0.55, AUC was 0.816. The sensitivity of WBC in 2 studies were 0.69 and 0.34, respectively; the sensitivity of WBC in 2 studies were 0.81 and 0.29, respectively; sensitivity and specificity of ANC were 0.87 and 0.40. Conclusions:When children having different thermal process, PCT provides a good specificity in the thermal process under 24 h, and provides a good sensitivity in the thermal process between 24 and 48 h. Since the heterogeneity among studies, it should be applied in combination with clinical features and other tests.