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Submitted: 29 January 2014
HERDIN Record #: R04A-DLSHSI-14012910080753

THE ACCURACY OF PROCALCITONIN IN THE DIAGNOSIS OF NEONATAL SEPSIS A META-ANALYSIS

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ABSTRACT

Objectives: A meta-analysis was carried out to assess the accuracy of the procalcitonin for the diagnosis of neonatal sepsis
Search Methods: A literature research was made in MEDLINE, EMBASE, Science Direct and Cochrane for published studies from inception until 2012. The search was limited to English language and human subjects.
Selection Criteria: Observational cohort and cross sectional studies with procalcitonin as index test and culture as reference standard were included. Methodological quality assessment of studies were assessed using QUADAS-2 tool.
Data Collection and Analysis: The 19 included studies were analysed using RevMan and MetaDiSc.
Results: Nineteen studies analysed a total of 2275 neonates.Subgroup analysis show that procalcitonin is more accurate for late onset sepsis (LR: +5.74,-0.19) than early onset sepsis (LR: +54.55,-0.33), cord sample (LR: +7.46,-0.29) than peripheral sample (LR: +2.55,-0.33) and immunochromatographic (LR: +8.29,-0.25) than immunoluminometric tests (LR: +3.65,-0.33). On comparison of different diagnostic tests, IL-6 has the highest Q* value of (0.85) followed by procalcitonin (0.81) then CRP (0.77). IL-6 also had higher positive LR and lower negative LR compared to procalcitonin and CRP.
Conclusion: Procalcitonin is a good diagnostic marker for neonatal sepsis. It is more sensitive for late onset sepsis and as a rapid diagnostic test. For early onset sepsis, cord blood sample is more accurate and when taken after 24th hour of life. IL-6 is the most sensitive diagnostic test followed by procalcitonin then by CRP.

Objectives

Objectives: A meta-analysis was carried out to assess the accuracy of the procalcitonin for the diagnosis of neonatal sepsis

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