title: The accuracy of presepsin for the diagnosis of sepsis from SIRS: a systematic review and meta-analysis.
abstract: BACKGROUND
  Sepsis is a common condition that has a high mortality and morbidity that need prompt diagnosis and treatment. Biomarkers like Soluble CD14 subtype (sCD14-ST, presepsin) may be useful in identifying patients with sepsis and its diagnostic superiority has been confirmed by several preliminary studies. The aim of this study was systematically and quantitatively to evaluate the value of presepsin for the diagnosis of sepsis through the method of meta-analysis.
  
  
  METHODS
  Four major databases, including MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library were systematically searched from inception to March 2015. Two investigators conducted the processes of literature search, study selection, data extraction, and quality evaluation independently. And the original data were extracted from all eligible individual studies to construct two-by-two tables.
  
  
  RESULTS
  A total of eight studies comprising 1757 patients were included in this meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio were 0.77 (95 % confidence interval [CI]: 0.75-0.80), 0.73 (95 % CI 0.69-0.77), and 14.25 (95 % CI 8.66-23.42), respectively. The summary receiver operating characteristic curve (SROC) area under the curve (AUC) was 0.8598. The subgroup analysis based on excluding the outliers showed that the pooled sensitivity and specificity were 0.85 (95 % CI 0.81-0.89) and 0.65 (95 % CI 0.59-0.70), respectively. The AUC was 0.8213 with no significant heterogeneity.
  
  
  CONCLUSIONS
  Presepsin has moderate diagnostic capacity for the detection of sepsis. Further research of presepsin is needed before widespread use in emergency department. And presepsin in combination with other laboratory biomarkers in diagnosing sepsis may be the focus of future studies.
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, 310009, China. zzj375367926@163.com.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, 310009, China. 13738062354@163.com.
authors.forename: Libing
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, 310009, China. yeligang@126.com.
authors.forename: Ligang
authors.initials: L
authors.lastname: Ye
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, 310009, China. gyz2010@126.com.
authors.forename: Yuzhi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, 310009, China. tangluping@163.com.
authors.forename: Luping
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine and Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, 310009, China. zmhzze@163.com.
authors.forename: Mao
authors.initials: M
authors.lastname: Zhang
keywords: Presepsin; SIRS; Sepsis; sCD14-ST