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降钙素原用于预测导管相关血流感染:一项荟萃分析。

Procalcitonin for predicting catheter-associated bloodstream infection: A meta-analysis.

作者信息

Jia Chun Mei, Feng Shun Yi, Li Yong, Cao Zong Xun, Wu Cheng Pu, Zhai Yan Zhao, Cui Jie, Zhang Meng, Gao Jie

机构信息

Emergency Department, Cangzhou Central Hospital, Cangzhou City, China.

出版信息

Medicine (Baltimore). 2019 Dec;98(52):e18546. doi: 10.1097/MD.0000000000018546.

Abstract

OBJECTIVE

The predictive accuracies of procalcitonin (PCT) in the diagnosis of catheter-associated bloodstream infection (CABSI) vary widely. This meta-analysis aimed to explore the predictive value of PCT for CABSI.

METHODS

We searched PubMed, EMBase, Web of Science, ScienceDirect, Cochrane Library, and studies published up to 10 March 2019. Odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated to evaluate PCT predictive value using Stata 14.0 software.

RESULTS

The meta-analysis was composed of 7 studies, consisting of 347 subjects. Pooled analysis demonstrated that a high PCT was significantly correlated with CABSI (pooled OR = 23.36, 95%CI 12.43-43.91, P < .001) and medium heterogenicity (I = 36.9%, P = .147). The pooled sensitivity and specificity were 85% (95%CI 0.76-0.91) and 89% (95%CI 0.68-0.97), respectively. Although Begg funnel plot (P = .007) indicated the presence of publication bias among the included studies, the stability of the pooled outcomes was verified by the trim-and-fill method. Furthermore, sensitivity analyses did not show important differences in effect estimation.

CONCLUSION

PCT is an effective predictor of CABSI. However, high-quality randomized controlled trials are needed to determine whether PCT could predict CABSI.

摘要

目的

降钙素原(PCT)在诊断导管相关血流感染(CABSI)中的预测准确性差异很大。本荟萃分析旨在探讨PCT对CABSI的预测价值。

方法

我们检索了PubMed、EMBase、科学引文索引、ScienceDirect、考克兰图书馆以及截至2019年3月10日发表的研究。使用Stata 14.0软件计算95%置信区间(95%CI)的比值比(OR),以评估PCT的预测价值。

结果

该荟萃分析由7项研究组成,共347名受试者。汇总分析表明,高PCT与CABSI显著相关(汇总OR = 23.36,95%CI 12.43 - 43.91,P <.001),且具有中等异质性(I = 36.9%,P =.147)。汇总敏感性和特异性分别为85%(95%CI 0.76 - 0.91)和89%(95%CI 0.68 - 0.97)。尽管Begg漏斗图(P =.007)表明纳入研究中存在发表偏倚,但通过修剪填充法验证了汇总结果的稳定性。此外,敏感性分析在效应估计方面未显示出重要差异。

结论

PCT是CABSI的有效预测指标。然而,需要高质量的随机对照试验来确定PCT是否能够预测CABSI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/573e/6946251/d31042d75f48/medi-98-e18546-g001.jpg

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