Department of the Cardiovascular Surgery.
School of Nursing, Southern Medical University, Guangzhou, China.
J Cardiovasc Med (Hagerstown). 2021 Apr 1;22(4):305-312. doi: 10.2459/JCM.0000000000001017.
Cardiac surgery with cardiopulmonary bypass (CPB) induces an acute inflammatory response that may lead to a systemic inflammatory response syndrome. The interest in procalcitonin (PCT) in the diagnosis of bacterial infection in patients after cardiac surgery remains less defined. The aim of this meta-analysis is to prospectively examine the discriminatory power of PCT as markers of infection in hospitalized patients with after cardiac surgery. The bivariate generalized nonlinear mixed-effect model and the hierarchical summary receiver operating characteristic model were used to estimate the pooled sensitivity, specificity and summary receiver operating characteristic curve. The pooled sensitivity and specificity were 0.81 (95% CI 0.75-0.87) and 0.78 (95% CI 0.73-0.83), respectively. The pooled positive likelihood ratio, and negative likelihood ratio of PCT were 3.74 (95% CI 2.98-4.69) and 0.24 (95% CI 0.17-0.32), respectively. The pooled area under the summary receiver operating characteristic curve of PCT using the HSROC method was 0.87 (95% CI 0.84- 0.90). This study indicated that PCT is a promising marker for the diagnosis of sepsis for those patients who undergo cardiac surgery.
体外循环心脏手术后会引发急性炎症反应，进而可能导致全身炎症反应综合征。降钙素原 (PCT) 在心脏手术后患者细菌感染诊断中的作用仍不明确。本荟萃分析旨在前瞻性研究 PCT 作为心脏手术后住院患者感染标志物的诊断价值。采用双变量广义非线性混合效应模型和层次综合受试者工作特征模型来估计汇总敏感性、特异性和综合受试者工作特征曲线。汇总敏感性和特异性分别为 0.81（95%置信区间 0.75-0.87）和 0.78（95%置信区间 0.73-0.83）。PCT 的汇总阳性似然比和阴性似然比分别为 3.74（95%置信区间 2.98-4.69）和 0.24（95%置信区间 0.17-0.32）。采用 HSROC 方法，PCT 的汇总受试者工作特征曲线下面积为 0.87（95%置信区间 0.84-0.90）。本研究表明，对于接受心脏手术的患者，PCT 是一种有前途的败血症诊断标志物。
