Procalcitonin Levels Correlates With The Pathogeny And Severity Of Community Acquired Pneumonia: A Meta-Analysis

Background: The purpose of this study was to comprehensively evaluate the role of PCT (procalcitonin) in diagnosis and prognosis of community acquired pneumonia (CAP) by a meta-analysis. Methods: Two researchers independently performed a retrieve on the databases of PubMed, Embase and Cochrane published in English up to July 2015. The search strategy was("community acquired pneumonia" OR CAP) AND procalcitonin. The risk ratio (RR) with 95% CI (confidence interval) was used for the analysis of dichotomous data. Standardized mean differences (SMD) and 95% CI were used to perform the analysis for continuous outcomes. All statistical analyses were performed by using RevMan (Review Manager) 5.3 software and Stata 12.0 statistical software package. Heterogeneity was analyzed with the Cochran Q test and I-2 test. Stata 12.0 was used to perform sensitivity analysis. Results: A total of 15 studies (6401 adult patients diagnosed with CAP) were selected in this meta-analysis. The number of patient mortality in PCT >= 0.5 ng/ml was twice that of PCT<0.5 ng/ml (RR = 0.50 (95% CI: 0.40, 0.62)). The number of patients that pathogen could be detected was 1.31 times that of could not be detected (RR = 1.31 (95% CI: 1.11, 1.55)). PCT levels of death cases were significantly higher than those of survival cases (SMD = -0.31 (95% CI: -0.50, -0.13)). The sensitivity analysis showed that this meta-analysis result was stable. Conclusions: Serum PCT levels are significantly related with detection of CAP pathogen and severity of CAP cases.