Serum procalcitonin as a diagnostic biomarker for sepsis in burned patients: A meta-analysis

Background: Sepsis is one of the main causes of mortality in severe burns. However, it is difficult to diagnose early. Procalcitonin (PCT) has been reported as a biomarker for sepsis with controversial results. The aim of the study is to assess the diagnostic value of serum PCT for sepsis in burn patients through a meta-analysis of published studies. Methods: A comprehensive literature search of PubMed, Embase, Web of Science and the Cochrane Library databases for studies published up to 1st March 2014 that evaluated PCT as a marker for diagnosing sepsis in burn patients was conducted. The summary receiver operating characteristic curves served to evaulate overall test performance. Meta-Disc 1.4 software and Stata 12.1 were used to analyze the data. Results: A total of 566 patients (samples) from nine trials were identified and analyzed. The pooled sensitivity and specificity were 0.74 and 0.88, respectively. No threshold effect was found among studies. The area under the SROC curve (AUC) was 0.92. Conclusion: The results suggest that serum PCT is a useful biomarker (AUC = 0.92) for early diagnosis of sepsis in burn patients. However, the results should be used with caution, because of obvious heterogeneity among those studies. Further large-scale research should regard more attention to the uniform cut-off value, and laboratories test methods. (C) 2014 Elsevier Ltd and ISBI. All rights reserved.