Post-operative serum procalcitonin vs C reactive Protein as a marker of post-operative infectious complications in pancreatic surgery – A systemic review and meta-analysis

C Reactive Protein ◽

Reactive Protein ◽

AbstractAim of StudyAim of this meta-analysis was to compare diagnostic accuracy of C reactive Protein and Procalcitonin between postoperative day 3 to 5 in predicting infectious complications post pancreatic surgery.MethodsSystemic literature search was performed using MEDLINE, EMBASE and SCOPUS to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) and C-Reactive Protein (CRP) as a predictor for detecting infectious complications between postoperative days (POD) 3 to 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters. Geometric means were calculated for PCT cut offs. The work has been reported in line with PRISMA guidelines.ResultsAfter applying inclusion and exclusion criteria 15 studies consisting of 2212 patients were included in the final analysis according to PRISMA guidelines. Pooled sensitivity, specificity, Area under curve and diagnostic odds ratio (DOR)for day 3 C-reactive protein was respectively 62%,67% 0.772 and 6.54. Pooled sensitivity, specificity, Area under curve and diagnostic odds ratio (DOR)for day 3 procalcitonin was respectively 74%,79%,0.8453 and 11.03. Sensitivity, specificity, Area under curve, and Diagnostic odds ratio for day 4 C-reactive protein was respectively 60%,68%, 0.8022 and 11.90. Pooled Sensitivity, specificity and Diagnostic odds ratio of post-operative day 5 procalcitonin level in predicting infectious complications were respectively 83%,70% and 12.9. Pooled Sensitivity, specificity, AUROC and diagnostic odds ratio were respectively 50%,70%, 0.777 and 10.19.ConclusionPost-operative procalcitonin is better marker to predict post-operative infectious complications after pancreatic surgeries and post-operative day 3 procalcitonin has highest diagnostic accuracy.

Post-operative day 3 Procalcitonin predicts post-operative infectious complications in pancreatic surgery A systemic review and updated meta-analysis.

10.1101/2020.09.21.20198994 ◽

2020 ◽

Author(s):

BHAVIN VASAVADA ◽

hardik patel

Keyword(s):

Odds Ratio ◽

Pancreatic Surgery ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Diagnostic Odds Ratio ◽

Systemic Review ◽

Geometric Means ◽

Aim of study: Aim of this meta-analysis is to evaluate post-operative procalcitonin as a marker to predict post- operative infectious complications after pancreatic surgeries. Material and Methods: Systemic literature search was performed using MEDLINE, EMBASE and to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) as a predictor for detecting infectious complications on postoperative days (POD) 3 and 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters for POD 3 and 5 were derived. Geometric means were calculated for PCT cut offs. Results: 6 studies included day 3 PCT analysis, 2 studies included both day 3 and day 5 analysis. Total data of 471 patients were derived. 161 patients developed infectious complications. Pooled sensitivity, specificity, pooled area under curve, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 3 PCT were 74%,79%,0.8453, 11.03,3.17 and 0.31 respectively. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 5 PCT were 83%,70%,12.91,2.91 and 0.25 respectively. Geometric means for PCT cut off for day 3 and 5 were 0.80 and 0.43. Conclusion: Postoperative procalcitonin particularly day 3 procalcitonin levels predict post-operative infectious complications following pancreatic surgeries.

Post-Operative Infectious Complications in Pancreatic Surgery – A Systemic Review and Updated Meta-analysis

10.20944/preprints202009.0545.v1 ◽

2020 ◽

Author(s):

BHAVIN Vasavada ◽

hardik patel

Keyword(s):

Odds Ratio ◽

Pancreatic Surgery ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Diagnostic Odds Ratio ◽

Systemic Review ◽

Geometric Means ◽

Aim of study:Aim of this meta-analysis is to evaluate post-operative procalcitonin as a marker to predict post- operative infectious complications after pancreatic surgeries.Material and Methods:Systemic literature search was performed using MEDLINE, EMBASE and to identify studies evaluating the diagnostic accuracy of Procalcitonin (PCT) as a predictor for detecting infectious complications on postoperative days (POD) 3 and 5 following pancreatic surgery. A meta-analysis was performed using random effect model and pooled predictive parameters for POD 3 and 5 were derived. Geometric means were calculated for PCT cut offs. Results:6 studies included day 3 PCT analysis, 2 studies included both day 3 and day 5 analysis. Total data of 471 patients were derived. 161 patients developed infectious complications. Pooled sensitivity, specificity, pooled area under curve, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 3 PCT were 74%,79%,0.8453, 11.03,3.17 and 0.31 respectively. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative like hood ratio of day 5 PCT were 83%,70%,12.91,2.91 and 0.25 respectively. Geometric means for PCT cut off for day 3 and 5 were 0.80 and 0.43. Conclusion:Postoperative procalcitonin particularly day 3 procalcitonin levels predict post-operative infectious complications following pancreatic surgeries.

C-reactive protein at 4 days after surgery as an early predictor of serious infectious complications following esophageal cancer surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.10 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 10-10

Author(s):

Kazuki Kano ◽

Takashi Ogata ◽

Yukio Maezawa ◽

Kenki Segami ◽

Tetsushi Nakajima ◽

...

Keyword(s):

Esophageal Cancer ◽

Diagnostic Accuracy ◽

Odds Ratio ◽

Cancer Surgery ◽

Multivariate Logistic Regression Model ◽

C Reactive Protein ◽

Term Survival ◽

Reactive Protein ◽

Esophageal Cancer Surgery

10 Background: Serious infectious complications (SICs), frequently observed morbidities, have been reported to be related not only with short-term mortality but also with poor long-term survival in various types of malignancies including esophageal cancer. SICs usually develop 7 to 10 days after esophagectomy and early diagnosis is believed to be difficult because systemic response by SICs is considered to be covered by surgical invasion. The aim of this study was to investigate whether serum C-reactive protein (CRP) on postoperative day (POD) 4 can be predictor of SICs after esophageal cancer surgery. Methods: The present study retrospectively examined 110 consecutive patients undergoing open thoracic esophagectomy after neoadjuvant chemotherapy for thoracic esophageal cancer between January 2011 and June 2015. All patients received perioperative care of enhanced recovery after surgery program with steroid therapy. SICs were defined as morbidity of grade III or more according to the Clavien-Dindo classification. Diagnostic accuracy was determined by measuring the area under the receiver operating characteristic curve (AUC). Clinical and laboratory parameters including CRP, all available before or within POD 4, were analyzed with univariate and multivariate logistic regression model to identify SICs. Results: Median age was 68 years. SICs were observed in 20 patients (18.2%). CRP on POD 4 had superior diagnostic accuracy for PICs (AUC 0.759; 95% confidence interval [CI], 0.652-0.866). Cut-off value for CRP was determined as 4.0 mg/dl which yielded a sensitivity of 70.0%, a specificity of 74.4% and a negative predictive value of 91.8% for the detection of SICs. Multivariate analysis identified CRP ≥ 4.0 mg/dl on POD 4 (odds ratio of 8.399 with 95% CI, 2.646–26.666) and three-field lymph node dissection (odds ratio of 4.658 with 95% CI, 1.306–16.619) as predictive factors for SICs after esophagectomy. Conclusions: CRP on POD 4 was an early indicator for serious infectious complications after esophageal cancer surgery, which could encourage imaging study to detect the focus or early intervention by antibiotics.

The diagnostic accuracy of B-mode ultrasound in detecting meniscal tears: a systematic review and pooled meta-analysis

Medical Ultrasonography ◽

10.11152/mu-1252 ◽

2018 ◽

Vol 20 (2) ◽

pp. 164 ◽

Cited By ~ 3

Author(s):

Fajin Dong ◽

Lei Zhang ◽

Shuxia Wang ◽

Duo Dong ◽

Jinfeng Xu ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Odds Ratio ◽

Meta Analysis ◽

Diagnostic Odds Ratio ◽

Cochrane Library ◽

Meniscal Tears ◽

Linear Probe ◽

Aim: To evaluate the diagnostic accuracy of meniscal tears using B-mode ultrasound and high-frequency linear probe by conducting a systematic review and pooled meta-analysis. Material and methods: The Cochrane library, Embase, and Pubmed were searched for relevant studies up to 29 July 2017. The arthroscopy was used as the reference standard. The results were estimated by pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under the summary receiver operating characteristic (SROC). Results: Seven prospective studies met the selection criteria, comprising 321meniscal tears from 472 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the SROC curve were 88.80% (95%CI: 82.83-92.87), 84.66% (95%CI: 75.89-90.64), 5.79(95%CI: 3.66-9.15), 0.13 (95%CI: 0.09-0.20), and 43.74 (95%CI: 24.01-79.68), respectively. The area under the SROC curve was 93% (95%CI: 91-95). Conclusions: This meta-analysis indicates that 2-dimensional ultrasound is useful, and could be routinely used for estimating meniscal injuries in the human knee joint

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

Medical Ultrasonography ◽

10.11152/mu-925 ◽

2017 ◽

Vol 19 (1) ◽

pp. 16 ◽

Cited By ~ 11

Author(s):

Yang Jiao ◽

Fajin Dong ◽

Hui Wang ◽

Lei Zhang ◽

Jinfeng Xu ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Shear Wave ◽

Likelihood Ratio ◽

Odds Ratio ◽

Meta Analysis ◽

Shear Wave Elastography ◽

Diagnostic Odds Ratio ◽

Liver Lesions ◽

Benign Lesions ◽

Aim: To investigate the clinical utility of shear wave elastography (SWE) imaging in the identification of malignant and benign lesions of the liver lesions by conducting a meta-analysis. Material and methods: The Cochrane library, Embase and Pubmed were searched for relevant studies with publication data through February 2016. Studies evaluating the diagnostic accuracy of SWE in the identification of malignant and benign lesions of the liver using SWE technology were selected. The cytology, histology or clinical imaging was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under hierarchical summary receiver operating characteristic curve (HSROC) were used to examine the diagnostic accuracy. Results: A total of 9 cohort studies involving 1046 liver lesions (malignant 679) from 968 patients were identified. All of the 9 studies were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWE in differentiating malignant and benign liver lesions were 82.2% (95% CI: 73.4–88.5), 80.2% (95% CI: 73.3–85.7), 4.159 (95% CI: 2.899–5.966), 0.222 (95% CI: 0.140–0.352), and 18.749 (95% CI: 8.746–40.195), respectively. The area under the HSROC curve was 87% (95% CI: 84–90). Conclusions: This meta-analysis indicates that SWE is useful in evaluating the stiffness of liver lesions and in differentiating between malignant and benign lesions. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWE can be considered as a useful complement to conventional ultrasonography.

Diagnostic Accuracy of 64-Slice Computed Tomography Angiography in Patients with Chest Pain vs. SPECT in the Assessment of Significant Coronary Artery Disease: A Systematic Review and Meta-analysis

Health Technology Assessment in Action ◽

10.18502/htaa.v4i2.6230 ◽

2021 ◽

Author(s):

Maryam Jamali ◽

Rajabali Daroudi ◽

Masih Tajdini ◽

Ali Akbari Sari ◽

Sajad Alaei ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Accuracy ◽

Odds Ratio ◽

Meta Analysis ◽

Diagnostic Odds Ratio ◽

Sensitivity Analyses ◽

Likelihood Ratios ◽

History Of ◽

Artery Disease ◽

Context: This systematic review and meta-analysis intended to investigate the diagnostic accuracy of computed tomography angiography (CTA) in comparison with single-photon emission computed tomography (SPECT) for the diagnosis of coronary artery disease (CAD) in chest pain patients with no history of cardiovascular diseases (CVDs). Methods: Invasive angiography was considered as the reference test with a stenosis threshold of ≥ 50%. Cochrane, Scopus, Science Direct, PubMed, and Embase databases were comprehensively searched from the time of inception of these databases to May 15, 2018. A manual search in Google Scholar, a reference review of the obtained studies, and a review of gray literature (including those presented in conferences and congresses) regarding diagnostic performances of CTA and SPECT techniques were performed independently by two researchers. A meta-analysis was performed to determine pooling estimates of sensitivity, specificity, diagnostic odds ratio, and positive as well as negative likelihood ratios in CTA and SPECT tests. According to the 2 × 2 contingency table of each study, at 0.95 confidence interval, the diagnostic accuracy of CTA and SPECT was meta-analyzed by pooling estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratios based on DerSimonian-Laird’s random-effects model. Heterogeneity was assessed by calculating I2. Analyses were performed using MetaDiSc version 1.4 and Stata version 11. The qualities of the selected studies were assessed independently by two researchers according to the quality assessment of diagnostic accuracy studies (QUADAS) questionnaire. Sensitivity analyses were performed by the Jackknife method. Publication bias was evaluated by Deeks’ funnel plot. Results: Fourteen studies related to CTA (1206 individuals) and 15 related to SPECT (1638 individuals) were eligible for meta-analysis. The pooled sensitivity and the specificity of CTA for CAD diagnosis were 91% (95% CI, 88% - 94%) and 87% (95% CI, 84% - 98%), respectively. The pooled positive and negative likelihood ratios, the diagnostic odds ratio, and the area under the ROC curve for CTA were 7.93 (95% CI, 5.11 - 12.29), 0.1 (95% CI, 0.06 - 0.17), 95.71 (95% CI, 59.81 - 153.15), and 0.96, respectively. The pooled sensitivity and the specificity of SPECT for CAD diagnosis were 81% (95% CI, 79% - 83%) and 74% (95% CI, 71% - 78%), respectively. The pooled positive and negative likelihood ratios, the diagnostic odds ratio, and the area under the ROC curve for SPECT were 3.03 (95% CI, 2.34 - 3.91), 0.25 (95% CI, 0.21 - 0.30), 13.56 (95% CI, 10.60 - 12.34), and 0.86, respectively. According to the sensitivity analyses, the removal of any single study at a time did not change the effect size of the remaining studies. We observed symmetry in the Deeks’ funnel plot, indicating that there was ignorable publication bias for CTA and SPECT studies. Conclusions: This study demonstrated that the diagnostic accuracies of CTA and SPECT tests lie in the ‘excellent’ and the ‘very good’ ranges, respectively. CTA is stronger evidence, than SPECT, to rule out CVDs in patients with low and intermediate risks of CAD with no history of cardiovascular diseases.

Accuracy of Enzyme-Linked Immunosorbent Assays (ELISAs) in Detecting Antibodies againstMycobacterium lepraein Leprosy Patients: A Systematic Review and Meta-Analysis

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/9828023 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Omar Ariel Espinosa ◽

Silvana Margarida Benevides Ferreira ◽

Fabiana Gulin Longhi Palacio ◽

Denise da Costa Boamorte Cortela ◽

Eliane Ignotti

Keyword(s):

Diagnostic Accuracy ◽

Odds Ratio ◽

Meta Analysis ◽

Characteristic Curve ◽

Diagnostic Odds Ratio ◽

Cochrane Library ◽

Likelihood Ratios ◽

Summary Receiver Operating Characteristic ◽

Immunosorbent Assays ◽

IgM againstMycobacterium lepraemay be detected by enzyme-linked immunosorbent assays (ELISAs) based on phenolic glycolipid I (PGL-I) or natural disaccharide octyl bovine serum albumin (ND-O-BSA) as antigens, and the IgG response can be detected by an ELISA based on lipid droplet protein 1 (LID-1). The titers of antibodies against these antigens vary with operational classification. The aim of this study was to compare the accuracy of ELISAs involving PGL-I and ND-O-BSA with that involving LID-1. We included studies that analyze multibacillary and paucibacillary leprosy cases and evaluate the diagnostic accuracy of ELISAs based on LID-1 and/or PGL-I or ND-O-BSA as antigens to measure antibody titers againstM. leprae. Studies were found via PubMed, the Virtual Health Library Regional Portal, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice Bibliográfico Espanhol de Ciências de Saúde, the Brazilian Society of Dermatology, National Institute for Health and Clinical Excellence, Cochrane Library, Embase (the Elsevier database), and Cumulative Index to Nursing and Allied Health Literature. The Quality Assessment of Diagnostic Accuracy Studies served as a methodological validity tool. Quantitative data were extracted using the Standards for Reporting of Diagnostic Accuracy. Sensitivity, specificity, and a diagnostic odds ratio were calculated, and a hierarchical summary receiver-operating characteristic curve and forest plots were constructed. The protocol register code for this meta-analysis is PROSPERO 2017: CRD42017055983. Nineteen studies were included. ND-O-BSA showed better overall performance in terms of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio when compared with PGL-I and LID-1. The multibacillary group showed better performance on these parameters (than the paucibacillary group did), at 94%, 99%, 129, 0.05, and 2293, respectively. LID-1 did not provide any advantage regarding the overall estimate of sensitivity in comparison with PGL-I or ND-O-BSA.