Abstract
BackgroundSepsis is one of the most common diseases that seriously threaten human health. Although a large number of markers related to sepsis have been reported in the last two decades, the diagnostic accuracy of these biomarkers remains unclear due to the lack of similar baselines among studies. Therefore, we conducted a large systematic review and meta-analysis to evaluate the diagnostic value of biomarkers from studies that included non-infectious systemic inflammatory response syndrome patients as a control group.MethodsWe searched Medline, Embase and the reference lists of identified studies beginning in April 2014. The last retrieval was updated in September 2016.ResultsUltimately, 86 articles fulfilled the inclusion criteria. Sixty biomarkers and 10,438 subjects entered the final analysis. The areas under the receiver operating characteristic curves for the 7 most common biomarkers, including procalcitonin, C-reactive protein, interleukin 6, soluble triggering receptor expressed on myeloid cells-1, presepsin, lipopolysaccharide binding protein and CD64, were 0.85, 0.77, 0.79, 0.85, 0.88, 0.71 and 0.96, respectively. The remaining 53 biomarkers exhibited obvious variances in diagnostic value and methodological quality.ConclusionsAlthough some biomarkers displayed moderate or above moderate diagnostic value for sepsis, the limitations of the methodological quality and sample size may weaken these findings. Currently, we still lack an ideal biomarker to aid in the diagnosis of sepsis. In the future, biomarkers with better diagnostic value as well as a combined diagnosis using multiple biomarkers are expected to solve the challenge of the diagnosis of sepsis.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-3591-5) contains supplementary material, which is available to authorized users.
Highlights
Sepsis is one of the most common diseases that seriously threaten human health
Over the last 20 years, many researchers have been dedicated to finding blood biomarkers for the early diagnosis of infection or sepsis, and they have obtained a substantial number of research results
We evaluated the quality of the included studies according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)
Summary
A large number of markers related to sepsis have been reported in the last two decades, the diagnostic accuracy of these biomarkers remains unclear due to the lack of similar baselines among studies. We conducted a large systematic review and meta-analysis to evaluate the diagnostic value of biomarkers from studies that included noninfectious systemic inflammatory response syndrome patients as a control group. Liu et al SpringerPlus (2016) 5:2091 increase in the early stage of the inflammatory response and show different expression between non-infectious inflammation and sepsis. Over the last 20 years, many researchers have been dedicated to finding blood biomarkers for the early diagnosis of infection or sepsis, and they have obtained a substantial number of research results. We performed a large-scale meta-analysis to summarize potential biomarkers for the differential diagnosis between non-infectious SIRS and sepsis
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