The Value Of Seum And CSF Procalcitonin In The Diagnosis Of Bacterial Meningitis After Neurosurgery:A Meta-analysis

Objective:To evaluate and analyze the diagnostic value of serum and cerebrospinal fluid procalcitonin(PCT)in bacterial meningitis after neurosurgery.Methods:PubMed,Embase,Cochrane Library,CBM,CNKI and Wanfang Data were searched with computer from the establishment of the database to January 2019,collecting the studies about the diagnostic value of serum and cerebrospinal fluid procalcitonin for bacterial meningitis.A quality assessment tool(QUADAS)was used to evaluated the quality of the included studies.Rev Man 5.3 and Stata16 statistical softwares was used for the meta-analysis.Through data collection,processing and finishing,access to sensitivity?specificity ? the postive likelihood ratio(PLR)? nagitive likelihood ratio(NLR)? the diagnostic odd ratio(DOR);the symmetric receiver operating characteristic curve(SROC)was drawn and the aera under curve was calculated to evaluate diagnostic value.Results:A total of 12 articles were included,totaling 882 patients.The Meta-analysis showed that the sensitivity of serum procalcitonin for the diagnosis of bacterial meningitis after neurosurgical procedure was 0.745(95%CI:0.579-0.852),the specificity was 0.832(95%CI : 0.708-0.909),the postive likelihood ratio(PLR)was 4.425(95%CI:2.309-8.480),the nagitive likelihood ratio(NLR)was 0.306(95%CI:0.178-0.529),the diagnond the area under the SROC curve(AUC)was 0.86(95%CI : 0.83-0.89;the sensitivity of cerebrospinal fluid procalcitonin for tstic odd ratio(DOR)was 14.441(95%CI:4.876-42.773),ahe diagnosis of bacterial meningitis after neurosurgical procedure was 0.833(95%CI:0.742-0.896),the specificity was 0.832(95%CI : 0.681-0.920),the postive likelihood ratio(PLR)was 4.969(95%CI :2.415-10.226),the nagitive likelihood ratio(NLR)was 0.201(95%CI:0.122-0.330),the diagnostic odd ratio(DOR)was 24.715(95%CI:8.494-71.916),and the area under the SROC curve(AUC)was 0.97(95%CI:0.95-0.98)?Conclusion:The serum and cerebrospinal fluid have hign diagnosis value to bacterial meningitis after neurosuegery,the cerebrospinal fluid is superior to the serm,can be uesd for the diagnosis of early intracranial infection.