Valor pronóstico de la proteína fijadora de lipopolisácaridos y la procalcitonina en pacientes con sepsis grave y shock séptico ingresados en una unidad de cuidados intensivos

Guadiana-Romualdo, L.M. García de; Rebollo-Acebes, S.; Esteban-Torrella, Patricia; Jiménez-Sánchez, R.; Ortin‐Freire, A.; Viqueira-González, M.; Trujillo‐Santos, Javier; Santos, Enrique Jiménez; Díaz, J. Pedregosa; Albaladejo-Otón, María Dolores; Allegue-Gallego, José Manuel

doi:10.1016/j.medin.2014.04.005

Cited by 8 publications

(2 citation statements)

References 24 publications

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“…Thirteen studies [24, 27, 28, 30–31, 35–36, 38–39, 42–45] were conducted in Europe, eight [25–26, 29, 32–33, 37, 41, 46] were conducted in Asia, one [40] was conducted in America, and one [34] in was conducted in Australia. With one exception [45], all studies were published in English. The mean age of patients varied between 45 and 75.8 years, and the proportion of men ranged from 44.8 to 70.4%.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic Value of Procalcitonin in Adult Patients with Sepsis: A Systematic Review and Meta-Analysis

Liu¹,

Su²,

Han³

et al. 2015

PLoS ONE

152

130

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Procalcitonin (PCT) has been widely investigated for its prognostic value in septic patients. However, studies have produced conflicting results. The purpose of the present meta-analysis is to explore the diagnostic accuracy of a single PCT concentration and PCT non-clearance in predicting all-cause sepsis mortality. We searched PubMed, Embase, Web of Knowledge and the Cochrane Library. Articles written in English were included. A 2 × 2 contingency table was constructed based on all-cause mortality and PCT level or PCT non-clearance in septic patients. Two authors independently evaluated study eligibility and extracted data. The diagnostic value of PCT in predicting prognosis was determined using a bivariate meta-analysis model. We used the Q-test and I 2 index to test heterogeneity. Twenty-three studies with 3,994 patients were included. An elevated PCT level was associated with a higher risk of death. The pooled relative risk (RR) was 2.60 (95% confidence interval (CI), 2.05–3.30) using a random-effects model (I 2 = 63.5%). The overall area under the summary receiver operator characteristic (SROC) curve was 0.77 (95% CI, 0.73–0.80), with a sensitivity and specificity of 0.76 (95% CI, 0.67–0.82) and 0.64 (95% CI, 0.52–0.74), respectively. There was significant evidence of heterogeneity for the PCT testing time (P = 0.020). Initial PCT values were of limited prognostic value in patients with sepsis. PCT non-clearance was a prognostic factor of death in patients with sepsis. The pooled RR was 3.05 (95% CI, 2.35–3.95) using a fixed-effects model (I 2 = 37.9%). The overall area under the SROC curve was 0.79 (95% CI, 0.75–0.83), with a sensitivity and specificity of 0.72 (95% CI, 0.58–0.82) and 0.77 (95% CI, 0.55–0.90), respectively. Elevated PCT concentrations and PCT non-clearance are strongly associated with all-cause mortality in septic patients. Further studies are needed to define the optimal cut-off point and the optimal definition of PCT non-clearance for accurate risk assessment.

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Section: Resultsmentioning

confidence: 99%

“…The mean age of patients varied between 45 and 75.8 years, and the proportion of men ranged from 44.8 to 70.4%. Twelve studies [25, 27, 30–31, 34, 39–45] included only patients with severe sepsis or septic shock. The most frequent source of sepsis was pulmonary infection.…”

Section: Resultsmentioning

confidence: 99%