title: Accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients: a systematic review and meta-analysis.
abstract: BACKGROUND
  Early diagnosis of sepsis is vital to the clinical course and outcome of septic patients. Recently, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) appears to be a potential marker of infection. The objective of this systematic review and meta-analysis was to evaluate the accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients.
  
  
  METHODS
  A systematic literature search of PubMed, Embase and Cochrane Central Register of Controlled Trials was performed using specific search terms (up to 15 October 2012). Studies were included if they assessed the accuracy of plasma sTREM-1 for sepsis diagnosis in adult patients with systemic inflammatory response syndrome (SIRS) and provided sufficient information to construct a 2 X 2 contingency table.
  
  
  RESULTS
  Eleven studies with a total of 1,795 patients were included. The pooled sensitivity and specificity was 79% (95% confidence interval (CI), 65 to 89) and 80% (95% CI, 69 to 88), respectively. The positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 4.0 (95% CI, 2.4 to 6.9), 0.26 (95% CI, 0.14 to 0.48), and 16 (95% CI, 5 to 46), respectively. The area under the curve of the summary receiver operator characteristic was 0.87 (95% CI, 0.84 to 0.89). Meta-regression analysis suggested that patient sample size and assay method were the main sources of heterogeneity. Publication bias was suggested by an asymmetrical funnel plot (P = 0.02).
  
  
  CONCLUSIONS
  The present meta-analysis showed that plasma sTREM-1 had a moderate diagnostic performance in differentiating sepsis from SIRS. Accordingly, plasma sTREM-1 as a single marker was not sufficient for sepsis diagnosis in systemic inflammatory patients.
authors.forename: Youping
authors.initials: Y
authors.lastname: Wu
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Fan
authors.forename: Rui
authors.initials: R
authors.lastname: Bao
authors.forename: Lulong
authors.initials: L
authors.lastname: Bo
authors.forename: Jinbao
authors.initials: J
authors.lastname: Li
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Deng
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D006801:Humans; D008562:Membrane Glycoproteins / Q000097:blood*; D011971:Receptors, Immunologic / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1