Abstract
IntroductionNeutrophil CD64 (nCD64) expression appears to be a promising marker of bacterial infections. The aim of this meta-analysis was to assess the accuracy of nCD64 expression for the diagnosis of sepsis in critically ill adult patients.MethodsWe systematically searched PubMed, Embase, ISI Web of Knowledge, and the Cochrane Library for literature published between database inception and 19 May 2014, as well as reference lists of identified primary studies. Studies were included if they included assessment of the accuracy of nCD64 expression for sepsis diagnosis in adult patients and provided sufficient information to construct a 2×2 contingency table.ResultsA total of 8 studies comprising 1986 patients fulfilled the inclusion criteria for the final analysis. The pooled sensitivity and specificity were 0.76 (95 % confidence interval [CI], 0.73–0.78) and 0.85 (95 % CI, 0.82–0.87), respectively. The positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 8.15 (95 % CI, 3.82–17.36), 0.16 (95 % CI, 0.09–0.30), and 60.41 (95 % CI, 15.87–229.90), respectively. The area under the summary receiver operating characteristic curve of nCD64 expression with Q* value were 0.95 (Q* =0.89).ConclusionsOn the basis of our meta-analysis, nCD64 expression is a helpful marker for early diagnosis of sepsis in critically ill patients. The results of the test should not be used alone to diagnose sepsis, but instead should be interpreted in combination with medical history, physical examination, and other test results.
Highlights
Neutrophil CD64 expression appears to be a promising marker of bacterial infections
As our results show that Neutrophil CD64 (nCD64) is not a perfect marker for sepsis, but an ideal marker does not exist, because sepsis is a complex, dynamic syndrome and no single test is sufficiently sensitive and specific for detecting sepsis
Conclusions our meta-analysis has various limitations exist, it suggests that nCD64 expression is a helpful marker for early diagnosis of sepsis in critically ill adult patients
Summary
Neutrophil CD64 (nCD64) expression appears to be a promising marker of bacterial infections. The aim of this meta-analysis was to assess the accuracy of nCD64 expression for the diagnosis of sepsis in critically ill adult patients. Sepsis is the most common cause of mortality in critically ill patients worldwide [1]. Early diagnosis sepsis and timely treatment can improve patients’ outcome and reduce costs [3, 4]. The diagnosis of sepsis is sometimes challenging, because the diagnosis is based on systemic inflammatory response syndrome (SIRS) in the presence of a known infection. SIRS is very common in many conditions, such as surgery, trauma, and pancreatitis [5, 6].
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