The role of mHLA-DR in the early diagnosis of sepsis patients with severe trauma: a meta-analysis
Abstract Background HLA-DR is a common and significant biomarker in sepsis. However, as a biomarker of post-traumatic sepsis, there are few studies. This meta-analysis was conducted to evaluate the value of HLA-DR in the diagnosis of severe traumatic sepsis. Methods We developed a strategy for literature retrieval from the PubMed, MEDLINE, Web of Science,EMBASE, and Cochrane Library databases. All studies published until June 1, 2021, were retrieved. All studies that were included considered HLA-DR in the diagnosis of adult post-traumatic sepsis, and each study calculated the sensitivities and specificities. Results The study included 8 articles involving 639 trauma patients. combined sensitivity was 0.81 (95% CI, 0.75–0.86), the combined specificity was 0.67 (95% CI, 0.62–0.71), the positive likelihood ratio was 2.29 (95% CI, 1.73–3.04), and the negative likelihood ratio was 0.32 (95% CI, 0.23–0.44). The area under the summary receiver operating characteristic curve was 0.84(95% CI, 0.80–0.87), and the Q index was 0.76. The combined diagnostic odds ratio was 9.11 (95% CI, 5.37–15.45). Conclusions The results of this meta-analysis showed that HLA-DR could be considered as a useful biomarker for the early diagnosis of severe traumatic sepsis. Its sensitivity and diagnostic abilities are excellent. However, its specificity is inadequate. Therefore, it should be combined with other clinical indicators to assess post-traumatic sepsis, and cannot be used in the diagnosis of a disease alone.