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Diagnostic accuracies of procalcitonin and C-reactive protein for bacterial infection in patients with systemic rheumatic diseases: a meta-analysis
G.G. Song1, S.-C. Bae2, Y.H. Lee3
- Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Hanyang University Medical Centre, Seoul, Korea.
- Division of Rheumatology, Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University Medical Centre, Seoul, Korea.
- Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Hanyang University Medical Centre, Seoul, Korea.
CER7657
2015 Vol.33, N°2
PI 0166, PF 0173
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PMID: 25602442 [PubMed]
Received: 07/06/2014
Accepted : 24/09/2014
In Press: 20/01/2015
Published: 09/04/2015
Abstract
OBJECTIVES:
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).
CONCLUSIONS:
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.
