Diagnostic accuracies of procalcitonin and C-reactive protein for bacterial infection in patients with systemic rheumatic diseases

A meta-analysis

Gwan Gyu Song, Sang Cheol Bae, Young Ho Lee

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: The purpose of this study was to compare the diagnostic performance of procalcitonin and C-reactive protein (CRP) for bacterial infection in patients with systemic rheumatic diseases. Methods: We searched Medline, Embase, and the Cochran library, and performed two meta-analyses on the diagnostic accuracy of procalcitonin and CRP for bacterial infection in systemic rheumatic disease patients. Results: A total of eight studies including 668 patients in whom the patients with bacterial infection were 208 were available for the meta-analysis. The pooled sensitivity and specificity of procalcitonin were 66.8% (95% confidence interval [CI] 60.0-73.2) and 89.8% (86.6-92.4), respectively, and those of CRP were 81.3% (75.3-86.3) and 63.0% (58.5-67.5). Procalcitonin PLR, NLR, and DOR were 5.930 (3.593-9.786), 0.352 (0.229-0.539), and 19.33 (10.25-36.45), respectively, and those for CRP were 2.228 (1.376-3.608), 0.367 (0.252-0.534), and 7.066 (3.559-14.03), respectively. The AUC of procalcitonin was 0.884 and the Q* index was 0.814, while the AUC of CRP was 0.789 and the Q* index was 0.726, which indicated that the diagnostic accuracy of procalcitonin in patients with systemic rheumatic diseases is higher than that of CRP (difference of AUC 0.095, 95% CI 0.004-0.185, p=0.039). When the data were limited to SLE, the specificity of procalcitonin was also significantly higher than that of CRP (difference 0.219, 95% CI 0.127-0.310, p<0.0001). Conclusion: Our meta-analysis of published studies demonstrates that procalcitonin is more specific and has better diagnostic accuracy than CRP for bacterial infection in systemic rheumatic diseases.

Original languageEnglish
Pages (from-to)166-173
Number of pages8
JournalClinical and Experimental Rheumatology
Volume33
Issue number2
Publication statusPublished - 2015 Jan 1

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Calcitonin
Rheumatic Diseases
Bacterial Infections
C-Reactive Protein
Meta-Analysis
Area Under Curve
Confidence Intervals
Libraries
Sensitivity and Specificity

Keywords

  • Bacterial infection
  • CRP
  • Diagnostic accuracy
  • Meta-analysis
  • Procalcitonin
  • Rheumatic diseases

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

@article{e7261e12fb0c4ff6aa8a2c389432e6c2,
title = "Diagnostic accuracies of procalcitonin and C-reactive protein for bacterial infection in patients with systemic rheumatic diseases: A meta-analysis",
abstract = "Objective: The purpose of this study was to compare the diagnostic performance of procalcitonin and C-reactive protein (CRP) for bacterial infection in patients with systemic rheumatic diseases. Methods: We searched Medline, Embase, and the Cochran library, and performed two meta-analyses on the diagnostic accuracy of procalcitonin and CRP for bacterial infection in systemic rheumatic disease patients. Results: A total of eight studies including 668 patients in whom the patients with bacterial infection were 208 were available for the meta-analysis. The pooled sensitivity and specificity of procalcitonin were 66.8{\%} (95{\%} confidence interval [CI] 60.0-73.2) and 89.8{\%} (86.6-92.4), respectively, and those of CRP were 81.3{\%} (75.3-86.3) and 63.0{\%} (58.5-67.5). Procalcitonin PLR, NLR, and DOR were 5.930 (3.593-9.786), 0.352 (0.229-0.539), and 19.33 (10.25-36.45), respectively, and those for CRP were 2.228 (1.376-3.608), 0.367 (0.252-0.534), and 7.066 (3.559-14.03), respectively. The AUC of procalcitonin was 0.884 and the Q* index was 0.814, while the AUC of CRP was 0.789 and the Q* index was 0.726, which indicated that the diagnostic accuracy of procalcitonin in patients with systemic rheumatic diseases is higher than that of CRP (difference of AUC 0.095, 95{\%} CI 0.004-0.185, p=0.039). When the data were limited to SLE, the specificity of procalcitonin was also significantly higher than that of CRP (difference 0.219, 95{\%} CI 0.127-0.310, p<0.0001). Conclusion: Our meta-analysis of published studies demonstrates that procalcitonin is more specific and has better diagnostic accuracy than CRP for bacterial infection in systemic rheumatic diseases.",
keywords = "Bacterial infection, CRP, Diagnostic accuracy, Meta-analysis, Procalcitonin, Rheumatic diseases",
author = "Song, {Gwan Gyu} and Bae, {Sang Cheol} and Lee, {Young Ho}",
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TY - JOUR

T1 - Diagnostic accuracies of procalcitonin and C-reactive protein for bacterial infection in patients with systemic rheumatic diseases

T2 - A meta-analysis

AU - Song, Gwan Gyu

AU - Bae, Sang Cheol

AU - Lee, Young Ho

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: The purpose of this study was to compare the diagnostic performance of procalcitonin and C-reactive protein (CRP) for bacterial infection in patients with systemic rheumatic diseases. Methods: We searched Medline, Embase, and the Cochran library, and performed two meta-analyses on the diagnostic accuracy of procalcitonin and CRP for bacterial infection in systemic rheumatic disease patients. Results: A total of eight studies including 668 patients in whom the patients with bacterial infection were 208 were available for the meta-analysis. The pooled sensitivity and specificity of procalcitonin were 66.8% (95% confidence interval [CI] 60.0-73.2) and 89.8% (86.6-92.4), respectively, and those of CRP were 81.3% (75.3-86.3) and 63.0% (58.5-67.5). Procalcitonin PLR, NLR, and DOR were 5.930 (3.593-9.786), 0.352 (0.229-0.539), and 19.33 (10.25-36.45), respectively, and those for CRP were 2.228 (1.376-3.608), 0.367 (0.252-0.534), and 7.066 (3.559-14.03), respectively. The AUC of procalcitonin was 0.884 and the Q* index was 0.814, while the AUC of CRP was 0.789 and the Q* index was 0.726, which indicated that the diagnostic accuracy of procalcitonin in patients with systemic rheumatic diseases is higher than that of CRP (difference of AUC 0.095, 95% CI 0.004-0.185, p=0.039). When the data were limited to SLE, the specificity of procalcitonin was also significantly higher than that of CRP (difference 0.219, 95% CI 0.127-0.310, p<0.0001). Conclusion: Our meta-analysis of published studies demonstrates that procalcitonin is more specific and has better diagnostic accuracy than CRP for bacterial infection in systemic rheumatic diseases.

AB - Objective: The purpose of this study was to compare the diagnostic performance of procalcitonin and C-reactive protein (CRP) for bacterial infection in patients with systemic rheumatic diseases. Methods: We searched Medline, Embase, and the Cochran library, and performed two meta-analyses on the diagnostic accuracy of procalcitonin and CRP for bacterial infection in systemic rheumatic disease patients. Results: A total of eight studies including 668 patients in whom the patients with bacterial infection were 208 were available for the meta-analysis. The pooled sensitivity and specificity of procalcitonin were 66.8% (95% confidence interval [CI] 60.0-73.2) and 89.8% (86.6-92.4), respectively, and those of CRP were 81.3% (75.3-86.3) and 63.0% (58.5-67.5). Procalcitonin PLR, NLR, and DOR were 5.930 (3.593-9.786), 0.352 (0.229-0.539), and 19.33 (10.25-36.45), respectively, and those for CRP were 2.228 (1.376-3.608), 0.367 (0.252-0.534), and 7.066 (3.559-14.03), respectively. The AUC of procalcitonin was 0.884 and the Q* index was 0.814, while the AUC of CRP was 0.789 and the Q* index was 0.726, which indicated that the diagnostic accuracy of procalcitonin in patients with systemic rheumatic diseases is higher than that of CRP (difference of AUC 0.095, 95% CI 0.004-0.185, p=0.039). When the data were limited to SLE, the specificity of procalcitonin was also significantly higher than that of CRP (difference 0.219, 95% CI 0.127-0.310, p<0.0001). Conclusion: Our meta-analysis of published studies demonstrates that procalcitonin is more specific and has better diagnostic accuracy than CRP for bacterial infection in systemic rheumatic diseases.

KW - Bacterial infection

KW - CRP

KW - Diagnostic accuracy

KW - Meta-analysis

KW - Procalcitonin

KW - Rheumatic diseases

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