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Comparison of the accuracy of hematological parameters in the diagnosis of neonatal sepsis: a network meta-analysis

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Abstract

Background

Currently, there are hundreds of hematological parameters used for rapid diagnosis of neonatal sepsis, but there is no network meta-analysis to compare the diagnostic efficacy of these parameters.

Methods

We searched for literature on the diagnostic neonatal sepsis and selected 20 of the most common parameters to compare their diagnostic efficacy. We used Bayesian network meta-analysis, Frequentist network meta-analysis, and individual traditional diagnostic meta-analysis to analyze the data and verify the stability of the results. Based on the above analysis, we ranked the diagnostic efficacy of 20 parameters and searched for the optimal indicator. We also conducted subgroup analysis based on different designs. GRADE was used to evaluate the quality of evidence.

Results

311 articles were included in the analysis, of which 206 articles were included in the network meta-analysis. Bayesian models fond the top three of the advantage index were P-SEP, SAA, and CD64. In Individual model, P-SEP, SAA, and CD64 had the best sensitivity; ABC, SAA, and P-SEP had the best specificity. Frequentist model showed that CD64, P-SEP, and IL-10 ranked in the top three for sensitivity, while P-SEP, ABC, and I/M in specificity. Overall, P-SEP, SAA, CD64, and PCT have good sensitivity and specificity among all the three methods. The results of subgroup analysis were consistent with the overall analysis. All evidence was mostly of moderate or low quality.

Conclusions

P-SEP, SAA, CD64, and PCT have good diagnostic efficacy for neonatal sepsis. However, further studies are required to confirm these findings.

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Data availability

No datasets were generated or analysed during the current study.

Abbreviations

EOS:

Early onset sepsis

LOS:

Late onset sepsis

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

TN:

True-negative

TP:

True-positive

FN:

False-negative

FP:

False-positive

QUADAS:

Quality Assessment of Diagnostic Accuracy Studies

SUCRA:

Surface under the cumulative ranking curve

SROC AUC:

Area under the summary receiver operating characteristic curve

PLR:

Positive likelihood ratio

NLR:

Negative likelihood ratio

IPA:

Importance Performance Analysis

ABC:

Absolute band count

ANC:

Absolute neutrophil count

CRP:

C-reactive protein

I/M:

Immature/ Mature neutrophil count ratio

I/T:

Immature/ Total neutrophils

IL-X:

Interleukin-X

M-ESR:

Micro-erythrocyte sedimentation rate

MPV:

Mean platelet volume

NLR:

Neutrophil to Lymphocyte Ratio

PCT:

Procalcitonin

PLT:

Platelet count

P-SEP:

Presepsin

SAA:

Serum amyloid A

TLC:

Total leucocyte count

TNF-α:

Tumor necrosis factor α

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Acknowledgements

We would like to express our gratitude to the authors of the original literature included in this article, as well as to AJE for providing language assistance during the writing of this manuscript.

Funding

This study did not receive any funding support.

Author information

Author notes

  1. Rong Huang and Tai-Liang Lu contributed equally to this work.

Authors and Affiliations

  1. Department of Laboratory, Panyu Hexian Memorial Hospital of Guangzhou, Guangzhou, 511400, China

    Rong Huang

  2. Department of Gastrointestinal Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, 410005, China

    Tai-Liang Lu

  3. Medical Insurance Office, Human Resources and Social Security Bureau of Guangzhou’s Nansha District, Guangzhou, 511466, China

    Ri-Hui Liu

Authors
  1. Rong Huang
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Contributions

HR: Study design, Data collection, Drafting of the manuscript; LTL: Study design, Data collection, Drafting of the manuscript; LRH: Study design, Data collection, Analysis and interpretation of data, Critical revision of the manuscript.

Corresponding author

Correspondence to Ri-Hui Liu.

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This article is a network meta-analysis and does not require approval or consent from an ethics committee.

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Competing interests

The authors declare no competing interests.

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Huang, R., Lu, TL. & Liu, RH. Comparison of the accuracy of hematological parameters in the diagnosis of neonatal sepsis: a network meta-analysis. Infection (2024). https://doi.org/10.1007/s15010-024-02354-2

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  • DOI: https://doi.org/10.1007/s15010-024-02354-2

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