Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis
BackgroundPostoperative infectious complications (PICs) are major concerns. Early and accurate diagnosis is critical for timely treatment and improved outcomes. Presepsin is an emerging biomarker for bacterial infections. However, its diagnostic efficacy for PICs across surgical specialties remains...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-12-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1320683/full |
| _version_ | 1797393439347703808 |
|---|---|
| author | Chun-Ying Lu Chia-Li Kao Kuo-Chuan Hung Jheng-Yan Wu Hui-Chen Hsu Chia-Hung Yu Wei-Ting Chang Wei-Ting Chang Wei-Ting Chang Ping-Hsun Feng I-Wen Chen |
| author_facet | Chun-Ying Lu Chia-Li Kao Kuo-Chuan Hung Jheng-Yan Wu Hui-Chen Hsu Chia-Hung Yu Wei-Ting Chang Wei-Ting Chang Wei-Ting Chang Ping-Hsun Feng I-Wen Chen |
| author_sort | Chun-Ying Lu |
| collection | DOAJ |
| description | BackgroundPostoperative infectious complications (PICs) are major concerns. Early and accurate diagnosis is critical for timely treatment and improved outcomes. Presepsin is an emerging biomarker for bacterial infections. However, its diagnostic efficacy for PICs across surgical specialties remains unclear.MethodsIn this study, a systematic search on MEDLINE, Embase, Google Scholar, and Cochrane Library was performed on September 30, 2023, to identify studies that evaluated presepsin for diagnosing PICs. PIC is defined as the development of surgical site infection or remote infection. Pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves were calculated. The primary outcome was the assessment of the efficacy of presepsin for PIC diagnosis, and the secondary outcome was the investigation of the reliability of procalcitonin or C-reactive protein (CRP) in the diagnosis of PICs.ResultsThis meta-analysis included eight studies (n = 984) and revealed that the pooled sensitivity and specificity of presepsin for PIC diagnosis were 76% (95% confidence interval [CI] 68%–82%) and 83% (95% CI 75%–89%), respectively. The HSROC curve yielded an area under the curve (AUC) of 0.77 (95% CI 0.73–0.81). Analysis of six studies on procalcitonin showed a combined sensitivity of 78% and specificity of 77%, with an AUC of 0.83 derived from the HSROC. Meanwhile, data from five studies on CRP indicated pooled sensitivity of 84% and specificity of 79%, with the HSROC curve yielding an AUC of 0.89.ConclusionPresepsin exhibits moderate diagnostic accuracy for PIC across surgical disciplines. Based on the HSROC-derived AUC, CRP has the highest diagnostic efficacy for PICs, followed by procalcitonin and presepsin. Nonetheless, presepsin demonstrated greater specificity than the other biomarkers. Further study is warranted to validate the utility of and optimize the cutoff values for presepsin.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023468358. |
| first_indexed | 2024-03-09T00:02:35Z |
| format | Article |
| id | doaj.art-fdfc995f4a4647b9852d74373f794456 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-09T00:02:35Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-fdfc995f4a4647b9852d74373f7944562023-12-12T16:13:11ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-12-011410.3389/fimmu.2023.13206831320683Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysisChun-Ying Lu0Chia-Li Kao1Kuo-Chuan Hung2Jheng-Yan Wu3Hui-Chen Hsu4Chia-Hung Yu5Wei-Ting Chang6Wei-Ting Chang7Wei-Ting Chang8Ping-Hsun Feng9I-Wen Chen10Department of Anesthesiology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Nutrition, Chi Mei Medical Center, Tainan, TaiwanDepartment of Otolaryngology, Kuang Tien General Hospital, Taichung, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Tainan, TaiwanSchool of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanDepartment of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, TaiwanBackgroundPostoperative infectious complications (PICs) are major concerns. Early and accurate diagnosis is critical for timely treatment and improved outcomes. Presepsin is an emerging biomarker for bacterial infections. However, its diagnostic efficacy for PICs across surgical specialties remains unclear.MethodsIn this study, a systematic search on MEDLINE, Embase, Google Scholar, and Cochrane Library was performed on September 30, 2023, to identify studies that evaluated presepsin for diagnosing PICs. PIC is defined as the development of surgical site infection or remote infection. Pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves were calculated. The primary outcome was the assessment of the efficacy of presepsin for PIC diagnosis, and the secondary outcome was the investigation of the reliability of procalcitonin or C-reactive protein (CRP) in the diagnosis of PICs.ResultsThis meta-analysis included eight studies (n = 984) and revealed that the pooled sensitivity and specificity of presepsin for PIC diagnosis were 76% (95% confidence interval [CI] 68%–82%) and 83% (95% CI 75%–89%), respectively. The HSROC curve yielded an area under the curve (AUC) of 0.77 (95% CI 0.73–0.81). Analysis of six studies on procalcitonin showed a combined sensitivity of 78% and specificity of 77%, with an AUC of 0.83 derived from the HSROC. Meanwhile, data from five studies on CRP indicated pooled sensitivity of 84% and specificity of 79%, with the HSROC curve yielding an AUC of 0.89.ConclusionPresepsin exhibits moderate diagnostic accuracy for PIC across surgical disciplines. Based on the HSROC-derived AUC, CRP has the highest diagnostic efficacy for PICs, followed by procalcitonin and presepsin. Nonetheless, presepsin demonstrated greater specificity than the other biomarkers. Further study is warranted to validate the utility of and optimize the cutoff values for presepsin.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023468358.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1320683/fullpresepsinprocalcitoninC-reactive proteinpostoperativeinfectious complicationsmeta-analysis |
| spellingShingle | Chun-Ying Lu Chia-Li Kao Kuo-Chuan Hung Jheng-Yan Wu Hui-Chen Hsu Chia-Hung Yu Wei-Ting Chang Wei-Ting Chang Wei-Ting Chang Ping-Hsun Feng I-Wen Chen Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis Frontiers in Immunology presepsin procalcitonin C-reactive protein postoperative infectious complications meta-analysis |
| title | Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis |
| title_full | Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis |
| title_fullStr | Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis |
| title_full_unstemmed | Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis |
| title_short | Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis |
| title_sort | diagnostic efficacy of serum presepsin for postoperative infectious complications a meta analysis |
| topic | presepsin procalcitonin C-reactive protein postoperative infectious complications meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1320683/full |
| work_keys_str_mv | AT chunyinglu diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT chialikao diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT kuochuanhung diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT jhengyanwu diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT huichenhsu diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT chiahungyu diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT weitingchang diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT weitingchang diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT weitingchang diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT pinghsunfeng diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis AT iwenchen diagnosticefficacyofserumpresepsinforpostoperativeinfectiouscomplicationsametaanalysis |