WITHDRAWN: The diagnostic accuracy of procalcitonin and C-reactive protein for sepsis: a systematic review and meta analysis

Abstract

// Meichun Tan 1 , Yunxia Lu 1 , Hao Jiang 1 and Liandong Zhang 1 1 Department of Emergency (include EICU), Shanghai Baoshan Traditional Chinese Medicine, Integrated Hospital, Shanghai 201999, China Correspondence to: Liandong Zhang, email: tanmeichun_2@126.com Keywords: sepsis; procalcitonin; C-reactive protein; meta analysis Received: August 31, 2017 Accepted: November 19, 2017 Published: January 02, 2018 ABSTRACT Objective: To systematic evaluate the clinical value of procalcitonin and C-reactive protein in the diagnosis of adult patients with sepsis. Materials and Methods: PubMed, Cochrane, Embase, Wanfang, CNKI, VIP database were searched by the index words to identified the qualified prospective studies, and relevant literature sources were also searched. The latest research was doing in the April 2017. The language were only included English or Chinese. In the experiment group patients were diagnosed with sepsis, severe sepsis or septic shock; in the control group patients were non-infectious origin or a systemic inflammatory response syndrome(SIRS). The diagnostic accuracy were analyzed by heterogeneity, diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the summary receiver operating characteristic curve. Results: At last 9 studies were involved in the meta-analysis with 495 patients in the sepsis group and 873 patients in the non-sepsis group. In the diagnostic accuracy of CRP for sepsis, the overall area under the SROC curve was 0.73 (95% CI:0.69–0.77), with a sensitivity and specificity of 0.80(95%CI:0.63–0.90) and 0.61(95%CI: 0.50–0.72) respectively, while the DOR was 6.89(95%CI:3.86–12.31). AS for the diagnostic accuracy of PCT for sepsis, the overall area under the SROC curve was 0.85 (95% CI:0.82–0.88), with a sensitivity and specificity of 0.80(95%CI:0.69–0.87) and 0.77 (95%CI:0.60–0.88) respectively, while the DOR was 12.50(95%CI: 3.65–42.80). Conclusions: In this meta-analysis, our results pooled indicate a moderate degree of value of PCT and CRP for diagnosis of sepsis in adult patients. The diagnosis accuracy and specificity of PCT is higher than that of CRP.