title: Biomarkers for diagnosis of sepsis in patients with systemic inflammatory response syndrome: a systematic review and meta-analysis.
abstract: BACKGROUND
  Sepsis is one of the most common diseases that seriously threaten human health. Although a large number of markers related to sepsis have been reported in the last two decades, the diagnostic accuracy of these biomarkers remains unclear due to the lack of similar baselines among studies. Therefore, we conducted a large systematic review and meta-analysis to evaluate the diagnostic value of biomarkers from studies that included non-infectious systemic inflammatory response syndrome patients as a control group.
  
  
  METHODS
  We searched Medline, Embase and the reference lists of identified studies beginning in April 2014. The last retrieval was updated in September 2016.
  
  
  RESULTS
  Ultimately, 86 articles fulfilled the inclusion criteria. Sixty biomarkers and 10,438 subjects entered the final analysis. The areas under the receiver operating characteristic curves for the 7 most common biomarkers, including procalcitonin, C-reactive protein, interleukin 6, soluble triggering receptor expressed on myeloid cells-1, presepsin, lipopolysaccharide binding protein and CD64, were 0.85, 0.77, 0.79, 0.85, 0.88, 0.71 and 0.96, respectively. The remaining 53 biomarkers exhibited obvious variances in diagnostic value and methodological quality.
  
  
  CONCLUSIONS
  Although some biomarkers displayed moderate or above moderate diagnostic value for sepsis, the limitations of the methodological quality and sample size may weaken these findings. Currently, we still lack an ideal biomarker to aid in the diagnosis of sepsis. In the future, biomarkers with better diagnostic value as well as a combined diagnosis using multiple biomarkers are expected to solve the challenge of the diagnosis of sepsis.
authors.affiliation: Intensive Care Unit, Suining Central Hospital, Deshengxi Road 127, Chuanshan District, Suining, 629000 Sichuan People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042 People's Republic of China.|State Key Laboratory of Trauma, Burn and Combined Injury, Trauma Center, Chongqing, 400042 People's Republic of China.
authors.forename: Jun-Huan
authors.initials: JH
authors.lastname: Hou
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042 People's Republic of China.|State Key Laboratory of Trauma, Burn and Combined Injury, Trauma Center, Chongqing, 400042 People's Republic of China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042 People's Republic of China.|State Key Laboratory of Trauma, Burn and Combined Injury, Trauma Center, Chongqing, 400042 People's Republic of China.
authors.forename: Kui-Jun
authors.initials: KJ
authors.lastname: Chen
authors.affiliation: Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors.forename: Shu-Nan
authors.initials: SN
authors.lastname: Wang
authors.affiliation: Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042 People's Republic of China.|State Key Laboratory of Trauma, Burn and Combined Injury, Trauma Center, Chongqing, 400042 People's Republic of China.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Wang
keywords: Biomarkers; Diagnosis; Meta-analysis; Sepsis; Systemic inflammatory response syndrome