The diagnostic accuracy of mid-regional pro-adrenomedullin for sepsis: a systematic review and meta-analysis

被引:21
作者
Li, Peijuan [1 ]
Wang, Chunmei [1 ]
Pang, Shuqin [1 ]
机构
[1] Capital Med Univ, Xuanwu Hosp, Dept Vasc Surg, 45 Changchun St, Beijing 100053, Peoples R China
关键词
Sensitivity and specificity; Human mid-regional pro-adrenomedullin; Sepsis; INFLAMMATORY RESPONSE SYNDROME; C-REACTIVE PROTEIN; SEPTIC SHOCK; SERUM PROCALCITONIN; ORGAN FAILURE; DEFINITIONS; BIOMARKERS; GUIDELINES; MANAGEMENT; PATIENT;
D O I
10.23736/S0375-9393.21.15585-3
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
INTRODUCTION: The incidence and mortality of sepsis are high, and common biomarkers are not perfect. To identify a biomarker with high specificity and sensitivity for sepsis, we evaluated the current literature on the performance of mid-regional pro-adrenomedullin (MR-proADM) in the diagnosis of sepsis. EVIDENCE ACQUISITION: According to appropriate eligibility and exclusion criteria, PubMed, EMBASE, Cochrane Library, China Journal full-text Database, Wanfang Database and Chinese Journal Full Text Database were searched for "mid-regional pro-adrenomedullin," "MR-proADM," "sepsis," "pyemia," "pyohemia," "septicemia," and "blood poisoning." The publication dates considered for the search were from inception until August 31st, 2020. The risk of bias was assessed according to QUADAS-2 criteria. EVIDENCE SYNTHESIS: Eleven studies involving 2038 cases were included. MR-proADM had high sensitivity and specificity in the diagnosis of sepsis, with values of 0.83 (95% CI: 0.79-0.87) and 0.90 (95% CI: 0.83-0.94), respectively. The odds ratio of a combined diagnosis was 41.35, and the area under the curve (AUC) was 0.91. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L. MR-proADM may also have value in distinguishing pathogens and identifying sepsis severity and organ failure. CONCLUSIONS: MR-proADM is an excellent biomarker for the diagnosis of sepsis with high sensitivity and specificity. The best cut-off value for MR-proADM diagnosis of sepsis is 1-1.5 nmol/L.
引用
收藏
页码:1117 / 1127
页数:11
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