Abstract
Background
The aim of this study was to assess the value of serum procalcitonin (PCT) levels
as a diagnostic marker for septic arthritis (SA) via meta-analysis.
Methods
We searched PubMed, Embase and the Cochrane Library, as well as the reference lists
of relevant articles, for studies published up to May 21, 2015 and did not impose
language restrictions. We selected original studies reporting the usefulness of PCT
or C-reactive protein (CRP) as a diagnostic marker for SA. We summarized test performance
characteristics with the use of forest plots, hierarchical summary receiver operating
characteristic curves, and bivariate random effects models. Prespecified subgroup
analyses and meta-regression analyses were also performed.
Results
This meta-analysis comprised 10 studies including 838 patients. The overall sensitivity
of serum PCT levels for the diagnosis of SA in these studies was 0.54 (95% CI, 0.41–0.66),
and the specificity of PCT was 0.95 (95% CI, 0.87–0.98). The positive likelihood ratio
(LR) was 10.97 (95% CI, 4.65–25.89); the negative LR was 0.49 (95% CI, 0.38–0.62);
and the area under ROC curve (AUROC) was 0.82 (95% CI, 0.78–0.85). Six studies also
examined the usefulness of CRP levels as a marker for the diagnosis of SA. The sensitivity
and specificity of CRP were 0.45 (95% CI, 0.35–0.55) and 0.079 (95% CI, 0.0.021–0.25),
respectively, and the positive LR, negative LR and AUROC curve were 0.48 (95% CI,
0.39–0.61), 6.79 (95% CI, 2.04–23.81), and 0.30 (95% CI, 0.26–0.34), respectively.
Conclusion
PCT is more valuable than CRP for distinguishing SA from non-SA.
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Article Info
Publication History
Published online: June 07, 2017
Accepted:
June 5,
2017
Received in revised form:
June 3,
2017
Received:
September 18,
2015
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
