NOVEL BIOMARKERS FOR EARLY DETECTION OF SEPSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

This meta-analysis documents the diagnostic accuracy of biomarkers useful to early detect sepsis with sTREM-1, Presepsin, and Procalcitonin. The included studies (n=14) were pooled to calculate estimates of sensitivity, specificity and areas under the curve (AUC) using a random-effects model. The findings indicated that the pooled results indicated that Presepsin displayed the best pooled sensitivity (85%) and specificity (90%) with sTREM-1 and Procalcitonin demonstrating moderate diagnostic efficacy (sensitivity of 78% and specificity of 84% in sTREM-1, sensitivity and specificity of 80% in Procalcitonin). The AUC in presepsin was the highest (0.91), meaning it is more diagnostic than other markers. They have shown that biomarkers M + Presepsin + procalcitonin have improved diagnostic performance compared to each individual (pooled sensitivity of 80% and specificity of 85 percent). Moderate heterogeneity among studies was also noted, with I2 values between 55% and 65%. The results validate the clinical usefulness of Presepsin emergent as the most valid biomarker to identify early sepsis, but in addition, show that multi-bottom panels potentially have greater angular sensitivity rates. Standardization of diagnostic protocols and assessment of clinical utility of synergistic biomarker strategies will require further work.