Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis

Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis

Introduction: The value of inflammatory biomarkers in the diagnosis of bacterial infection induced acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is currently unclear. Our objective was to investigate the diagnostic accuracy of on-admission inflammatory biomarkers in differenti...

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Autores principales: Piroska Pázmány, Alexandra Soós, Péter Hegyi, Dóra Dohos, Szabolcs Kiss, Zsolt Szakács, Andrea Párniczky, András Garami, Zoltán Péterfi, Zsolt Molnár
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
Materias:
chronic objective pulmonary disease
bacterial infection
acute exacerbation
inflammatory biomarker
diagnostic accuracy
meta-analysis
Medicine (General)
R5-920
Acceso en línea:https://doaj.org/article/6fc64c9501a24da58f113275a9e97570
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spelling oai:doaj.org-article:6fc64c9501a24da58f113275a9e975702021-11-18T06:36:02ZInflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis2296-858X10.3389/fmed.2021.639794https://doaj.org/article/6fc64c9501a24da58f113275a9e975702021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.639794/fullhttps://doaj.org/toc/2296-858XIntroduction: The value of inflammatory biomarkers in the diagnosis of bacterial infection induced acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is currently unclear. Our objective was to investigate the diagnostic accuracy of on-admission inflammatory biomarkers in differentiating bacterial origin in AECOPD.Methods: Systematic literature search was performed to include cross-sectional studies on AECOPD patients with microbiological culture results as gold standard, and at least one on-admission inflammatory biomarker determined from serum: C-reactive protein (CRP), procalcitonin (PCT), neutrophil/lymphocyte ratio, eosinophil percentage, CD64index; or sputum: neutrophil elastase, tumor necrosis factor alfa, interleukin-1-beta (IL-1b), interleukin-8, sputum color, as index tests. We ranked index tests by superiority indices in a network meta-analysis and also calculated pooled sensitivity and specificity.Results: Altogether, 21 eligible articles reported data on 2,608 AECOPD patients (44% bacterial). Out of the 14 index tests, sputum IL-1b showed the highest diagnostic performance with a pooled sensitivity of 74% (CI: 26–97%) and specificity of 65% (CI: 19–93%). Pooled sensitivity for CRP and PCT were: 67% (CI: 54–77%) and 54% (CI: 39–69%); specificity 62% (CI: 52–71%) and 71% (CI: 59–79%), respectively.Conclusion: Admission inflammatory biomarkers are inaccurate indicators of bacterial infection in AECOPD.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#myprospero, identifier: 42020161301.Piroska PázmányPiroska PázmányPiroska PázmányAlexandra SoósPéter HegyiPéter HegyiPéter HegyiPéter HegyiDóra DohosSzabolcs KissSzabolcs KissZsolt SzakácsZsolt SzakácsAndrea PárniczkyAndrea PárniczkyAndrea PárniczkyAndrás GaramiZoltán PéterfiZsolt MolnárZsolt MolnárZsolt MolnárZsolt MolnárZsolt MolnárFrontiers Media S.A.articlechronic objective pulmonary diseasebacterial infectionacute exacerbationinflammatory biomarkerdiagnostic accuracymeta-analysisMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic chronic objective pulmonary disease
bacterial infection
acute exacerbation
inflammatory biomarker
diagnostic accuracy
meta-analysis
Medicine (General)
R5-920
spellingShingle chronic objective pulmonary disease
bacterial infection
acute exacerbation
inflammatory biomarker
diagnostic accuracy
meta-analysis
Medicine (General)
R5-920
Piroska Pázmány
Piroska Pázmány
Piroska Pázmány
Alexandra Soós
Péter Hegyi
Péter Hegyi
Péter Hegyi
Péter Hegyi
Dóra Dohos
Szabolcs Kiss
Szabolcs Kiss
Zsolt Szakács
Zsolt Szakács
Andrea Párniczky
Andrea Párniczky
Andrea Párniczky
András Garami
Zoltán Péterfi
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis
description Introduction: The value of inflammatory biomarkers in the diagnosis of bacterial infection induced acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is currently unclear. Our objective was to investigate the diagnostic accuracy of on-admission inflammatory biomarkers in differentiating bacterial origin in AECOPD.Methods: Systematic literature search was performed to include cross-sectional studies on AECOPD patients with microbiological culture results as gold standard, and at least one on-admission inflammatory biomarker determined from serum: C-reactive protein (CRP), procalcitonin (PCT), neutrophil/lymphocyte ratio, eosinophil percentage, CD64index; or sputum: neutrophil elastase, tumor necrosis factor alfa, interleukin-1-beta (IL-1b), interleukin-8, sputum color, as index tests. We ranked index tests by superiority indices in a network meta-analysis and also calculated pooled sensitivity and specificity.Results: Altogether, 21 eligible articles reported data on 2,608 AECOPD patients (44% bacterial). Out of the 14 index tests, sputum IL-1b showed the highest diagnostic performance with a pooled sensitivity of 74% (CI: 26–97%) and specificity of 65% (CI: 19–93%). Pooled sensitivity for CRP and PCT were: 67% (CI: 54–77%) and 54% (CI: 39–69%); specificity 62% (CI: 52–71%) and 71% (CI: 59–79%), respectively.Conclusion: Admission inflammatory biomarkers are inaccurate indicators of bacterial infection in AECOPD.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#myprospero, identifier: 42020161301.
format article
author Piroska Pázmány
Piroska Pázmány
Piroska Pázmány
Alexandra Soós
Péter Hegyi
Péter Hegyi
Péter Hegyi
Péter Hegyi
Dóra Dohos
Szabolcs Kiss
Szabolcs Kiss
Zsolt Szakács
Zsolt Szakács
Andrea Párniczky
Andrea Párniczky
Andrea Párniczky
András Garami
Zoltán Péterfi
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
author_facet Piroska Pázmány
Piroska Pázmány
Piroska Pázmány
Alexandra Soós
Péter Hegyi
Péter Hegyi
Péter Hegyi
Péter Hegyi
Dóra Dohos
Szabolcs Kiss
Szabolcs Kiss
Zsolt Szakács
Zsolt Szakács
Andrea Párniczky
Andrea Párniczky
Andrea Párniczky
András Garami
Zoltán Péterfi
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
Zsolt Molnár
author_sort Piroska Pázmány
title Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis
title_short Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis
title_full Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis
title_fullStr Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis
title_full_unstemmed Inflammatory Biomarkers Are Inaccurate Indicators of Bacterial Infection on Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease—A Systematic Review and Diagnostic Accuracy Network Meta-Analysis
title_sort inflammatory biomarkers are inaccurate indicators of bacterial infection on admission in patients with acute exacerbation of chronic obstructive pulmonary disease—a systematic review and diagnostic accuracy network meta-analysis
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/6fc64c9501a24da58f113275a9e97570
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