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Research
Revisit Eosinopenia as a Biomarker for Diagnosis of Sepsis: A Meta-Analysis
Zhaocai Zhang
Second Affiliated Hospital, Zhejiang University School of medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4709-066X
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This work is licensed under a CC BY 4.0 License. Read Full License
Background
Sepsis is a life-threatening and time-critical medical emergency, therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. So, we performed a meta-analysis to assess the diagnostic efficacy of eosinopenia for sepsis.
Method
We searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials CENTRAL databases to identify studies that met the inclusion criteria. Two authors performed data extraction independently. The pooled outcomes were calculated by TP (true positive), FP (false positive), FN (false negative), TN (true negative) by using bivariate meta-analysis model in STATA 14.0 software.
Results
Seven studies were included in the present study with a total number of 3842 subjects. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.66 (95%CI [0.53-0.77]), 0.68 (95%CI [0.56-0.79]), 2.09 (95%CI [1.44-3.02]), 0.49 (95%CI [0.34-0.71]) and 4.23 (95%CI [2.15-8.31]), respectively. The area under the summary receiver operator characteristic curve (SROC) was 0.73 (95%CI [0.68-0.76]). Meta-regression analysis revealed that no single parameter accounted for the heterogeneity of pooled outcomes. For each subgroup of different eosinopenia cutoff values (50, 40, <=25, 100), the sensitivity was 0.61, 0.79, 0.57, 0.54, and the specificity was 0.61, 0.75, 0.83, 0.51, respectively.
Conclusions
Our findings suggest that eosinopenia shows no superiority in the diagnosis of sepsis. Further large clinical trials are needed to re-evaluate eosinopenia as a biomarker of sepsis.
Keywords
Sepsis, diagnosis, eosinopenia, biomarker, meta-analysis
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- Suppl.fig.6metaregressionsummary.tif
- Suppl.fig.5fagan.png
- Suppl.fig.4DORforest.png
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- Suppl.fig.2Deekspubbias.png
- Suppl.fig.1qualityassessmentsummary.png
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Research
Revisit Eosinopenia as a Biomarker for Diagnosis of Sepsis: A Meta-Analysis
Zhaocai Zhang
Second Affiliated Hospital, Zhejiang University School of medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4709-066X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Aug, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Sepsis is a life-threatening and time-critical medical emergency, therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. So, we performed a meta-analysis to assess the diagnostic efficacy of eosinopenia for sepsis.
Method
We searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials CENTRAL databases to identify studies that met the inclusion criteria. Two authors performed data extraction independently. The pooled outcomes were calculated by TP (true positive), FP (false positive), FN (false negative), TN (true negative) by using bivariate meta-analysis model in STATA 14.0 software.
Results
Seven studies were included in the present study with a total number of 3842 subjects. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.66 (95%CI [0.53-0.77]), 0.68 (95%CI [0.56-0.79]), 2.09 (95%CI [1.44-3.02]), 0.49 (95%CI [0.34-0.71]) and 4.23 (95%CI [2.15-8.31]), respectively. The area under the summary receiver operator characteristic curve (SROC) was 0.73 (95%CI [0.68-0.76]). Meta-regression analysis revealed that no single parameter accounted for the heterogeneity of pooled outcomes. For each subgroup of different eosinopenia cutoff values (50, 40, <=25, 100), the sensitivity was 0.61, 0.79, 0.57, 0.54, and the specificity was 0.61, 0.75, 0.83, 0.51, respectively.
Conclusions
Our findings suggest that eosinopenia shows no superiority in the diagnosis of sepsis. Further large clinical trials are needed to re-evaluate eosinopenia as a biomarker of sepsis.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6