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J Pediatr Intensive Care
DOI: 10.1055/s-0042-1758479
Review Article

The Role of Presepsin as a Biomarker of Sepsis in Children: A Systemic Review and Meta-Analysis

Daisy Khera
1   Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Nisha Toteja
2   Department of Paediatrics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
,
Simranjeet Singh
1   Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Siyaram Didel
1   Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Kuldeep Singh
1   Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Ankita Chugh
3   Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Surjit Singh 
4   Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Abstract

Objectives Biomarkers in sepsis are an arena of avid research as they can facilitate timely diagnosis and help reduce mortality. Presepsin is a promising candidate with good diagnostic performance reported in adult and neonatal studies. However, there is no clear consensus about its utility in the pediatric age group. This study aimed to synthesize scientific evidence regarding the diagnostic and prognostic performance of presepsin in pediatric sepsis.

Data Sources A systematic literature search was conducted in MEDLINE/PubMed, Cochrane Central Register of Clinical Trials, Google Scholar, and Scopus to identify relevant studies reporting the diagnostic and prognostic accuracy of presepsin.

Study Selection Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we retrieved all controlled trials and observational studies on presepsin as a biomarker in children aged <19 years with sepsis.

Data Extraction Two authors independently performed study screening, data extraction, and quality assessment of the included studies.

Data Synthesis Among the 267 citations identified, a total of nine relevant studies were included in the final analysis. The pooled diagnostic sensitivity and specificity of presepsin were 0.99 (95% confidence interval [CI]; 0.97–1.00) and 0.88 (95% CI; 0.83–0.92), respectively, with a diagnostic odds ratio (DOR) of 28.15 (95% CI; 0.74–1065.67) and area under the curve (AUC) in summary receiver operating curve of 0.89. Prognostic accuracy for presepsin had a sensitivity of 0.64 (95% CI; 0.35–1.0), specificity of 0.62 (95% CI; 0.44–0.87), and DOR of 3.3 (95% CI; 0.20–53.43). For procalcitonin, the pooled sensitivity for diagnostic accuracy was 0.97 (95% CI; 0.94–1.00), specificity was 0.76 (95% CI; 0.69–0.82), DOR was 10.53 (95% CI; 5.31–20.88), and AUC was 0.81.

Conclusion Presepsin has good diagnostic accuracy with high sensitivity and specificity. Its prognostic accuracy in predicting mortality is low.

Keywords

sepsis - presepsin - diagnosis - meta-analysis - children - sensitivity - specificity

Clinical Trial Registration

Not applicable.


Ethical Approval and Consent to Participate

Not Applicable.


Consent for Publication

Not applicable.


Availability of Supporting Data

The datasets used and/or analyzed during the current study are available from the corresponding author on request.


Authors Contribution

All of the authors were responsible for study design and planning of systematic review; D.K. and S.S.1 were responsible for literature search; SS2 and DK were responsible for figures; D.K., S.S.2, and S.S.1 were responsible for tables; S.S.2 and D.K. were responsible for data collection and analysis; D.K., A.C., S.S.2 were responsible for risk of bias; S.S.2, A.C., and D.K. were responsible for GRADE Analysis; and S.S.2 and D.K. were responsible for data interpretation; N.T., D.K., S.S.2, S.S.1, K.S., S.D., and A.C. were responsible for writing. All of the authors were responsible for resolving queries and corrections and final approval of manuscript. -


Note

The corresponding author attests that all listed authors meet authorship criteria as per ICJME and that the manuscript is an honest, accurate, and transparent account of the study being reported.


Name of the institution where the work was performed:- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.


Supplementary Material



Publication History

Received: 20 May 2022

Accepted: 28 September 2022

Article published online:
17 November 2022

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