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      Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis.

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          Abstract

          Procalcitonin is widely reported as a useful biochemical marker to differentiate sepsis from other non-infectious causes of systemic inflammatory response syndrome. In this systematic review, we estimated the diagnostic accuracy of procalcitonin in sepsis diagnosis in critically ill patients. 18 studies were included in the review. Overall, the diagnostic performance of procalcitonin was low, with mean values of both sensitivity and specificity being 71% (95% CI 67-76) and an area under the summary receiver operator characteristic curve of 0.78 (95% CI 0.73-0.83). Studies were grouped into phase 2 studies (n=14) and phase 3 studies (n=4) by use of Sackett and Haynes' classification. Phase 2 studies had a low pooled diagnostic odds ratio of 7.79 (95% CI 5.86-10.35). Phase 3 studies showed significant heterogeneity because of variability in sample size (meta-regression coefficient -0.592, p=0.017), with diagnostic performance upwardly biased in smaller studies, but moving towards a null effect in larger studies. Procalcitonin cannot reliably differentiate sepsis from other non-infectious causes of systemic inflammatory response syndrome in critically ill adult patients. The findings from this study do not lend support to the widespread use of the procalcitonin test in critical care settings.

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          Author and article information

          Journal
          Lancet Infect Dis
          The Lancet. Infectious diseases
          Elsevier BV
          1473-3099
          1473-3099
          Mar 2007
          : 7
          : 3
          Affiliations
          [1 ] Department of Intensive Care Medicine, Nepean Hospital, Penrith, New South Wales, Australia. McleanA@wahs.nsw.gov.au
          Article
          S1473-3099(07)70052-X
          10.1016/S1473-3099(07)70052-X
          17317602
          b0385a54-ecab-4f64-8bc1-9377db2cb3eb
          History

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