Diagnostic and prognostic accuracy of Protein C in adult patients with sepsis: protocol for a systematic review and meta-analysis

Catenacci, Vanessa; Sheikh, Fatima; Patel, Karan; Fox-Robichaud, Alison

doi:10.1136/bmjopen-2021-050754

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…This systematic review and meta-analysis was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [ 17 ]. The protocol of this systematic review has been published in BMJ Open [ 18 ]. The systematic review was registered in PROSPERO (CRD42021229786).…”

Section: Methodsmentioning

confidence: 99%

The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis

et al. 2022

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Background Sepsis, the dysregulated host response to infection, triggers abnormal pro-coagulant and pro-inflammatory host responses. Limitations in early disease intervention highlight the need for effective diagnostic and prognostic biomarkers. Protein C’s role as an anticoagulant and anti-inflammatory molecule makes it an appealing target for sepsis biomarker studies. This meta-analysis aims to assess the diagnostic and prognostic value of protein C (PC) as a biomarker for adult sepsis. Methods We searched MEDLINE, PubMed, EMBASE, CINAHL and Cochrane Library from database inception to September 12, 2021. We included prospective observational studies of (1) adult patients (> 17) with sepsis or suspicion of sepsis that; (2) measured PC levels with 24 h of study admission with; and (3) the goal of examining PC as a diagnostic or prognostic biomarker. Two authors screened articles and conducted risk of bias (RoB) assessment, using the Quality in Prognosis Studies (QUIPS) and the Quality Assessment in Diagnostic Studies-2 (QUADAS-2) tools. If sufficient data were available, meta-analysis was conducted to estimate the standardized mean difference (SMD) between patient populations. Results Twelve studies were included, and 8 were synthesized for meta-analysis. Pooled analysis demonstrated moderate certainty of evidence that PC levels were less reduced in sepsis survivors compared to non-survivors (6 studies, 741 patients, SMD = 0.52, 95% CI 0.24–0.81, p = 0.0003, I2 = 55%), and low certainty of evidence that PC levels were less reduced in septic patients without disseminated intravascular coagulation (DIC) compared to those with DIC (3 studies, 644 patients, SMD = 0.97, 95% CI 0.62–1.32, p < 0.00001, I2 = 67%). PC could not be evaluated as a diagnostic tool due to heterogeneous control populations between studies. Conclusion and relevance Our review demonstrates that PC levels were significantly higher in sepsis survivors compared to non-survivors and patients with sepsis but not disseminated intravascular coagulation (DIC). Our evaluation is limited by high RoB in included studies and poor reporting of the sensitivity and specificity of PC as a sepsis biomarker. Future studies are needed to determine the sensitivity and specificity of PC to identify its clinical significance as a biomarker for early sepsis recognition. Trial Registration PROSPERO registration number: CRD42021229786. The study protocol was published in BMJ Open.

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Section: Methodsmentioning

confidence: 99%

The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis

et al. 2022

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Coagulative Biomarkers Differently Predict Clinical Outcomes in Invasive Infections Caused by Neisseria Meningitidis and Streptococcus Pneumoniae

Meini,

Bracalente,

Sbrana

et al. 2024

The American Journal of Medicine

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A Meta-Analysis of Predictive Value of Blood Biomarkers in Gestational Trophoblastic Neoplasia

Guo,

Zhang,

et al. 2024

Future Oncol.

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Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported to play a diagnostic and predictive role in gestational trophoblastic disease. However, the conclusions are still ambiguous. This meta-analysis aimed to evaluate the combined predictive value of NLR and PLR in the malignant progression of gestational trophoblastic disease. Method: Electronic databases including PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, Wanfang and China Biomedical Literature Database were searched for the relevant literature published up to 1 October 2022. Study selection and data extraction were performed independently by two reviewers. All analyses were performed using Revman, MetaDisc and STATA software. Results: A total of 858 patients from five studies were included in this meta-analysis. The pooled sensitivity and specificity of NLR were 0.8 (95% CI: 0.71–0.88) and 0.73 (95% CI: 0.69–0.76), respectively, and the area under curve of the summary receiver operating curve was 0.81. The pooled sensitivity and specificity of PLR were 0.87 (95% CI: 0.75–0.95) and 0.49 (95% CI: 0.44–0.54), respectively, and the area under curve of the summary receiver operating curve was 0.88. I2 statistic and Deek's funnel plot showed no heterogeneity and publication bias. Conclusion: NLR can accurately predict the progression from hydatidiform mole to gestational trophoblastic neoplasia and is a promising biomarker in further follow-up.

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Diagnostic and prognostic accuracy of Protein C in adult patients with sepsis: protocol for a systematic review and meta-analysis

Cited by 3 publications

References 31 publications

The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis

The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis

Coagulative Biomarkers Differently Predict Clinical Outcomes in Invasive Infections Caused by Neisseria Meningitidis and Streptococcus Pneumoniae

A Meta-Analysis of Predictive Value of Blood Biomarkers in Gestational Trophoblastic Neoplasia

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