Diagnostic accuracy of lipopolysaccharide-binding protein as biomarker for sepsis in adult patients: A systematic review and meta-analysis

Kuan Fu Chen, Chung Hsien Chaou, Jing Yi Jiang, Hsueh Wen Yu, Yu Hsiang Meng, Wei Chen Tang, Chin Chieh Wu

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28 Scopus citations

Abstract

Introduction Lipopolysaccharide-binding protein (LBP) is widely reported as a biomarker to differentiate infected from non-infected patients. The diagnostic use of LBP for sepsis remains a matter of debate. We aimed to perform a systematic review and meta-analysis to assess the diagnostic accuracy of serum LBP for sepsis in adult patients. Methods We performed a systematic review and meta-analysis to assess the accuracy of LBP for sepsis diagnosis. A systematic search in PubMed and EMBASE for studies that evaluated the diagnostic role of LBP for sepsis through December 2015 was conducted. We searched these databases for original, English language, research articles that studied the diagnostic accuracy between septic and non-septic adult patients. Sensitivity, specificity, and other measures of accuracy, such as diagnostic odds ratio (DOR) and area under the receiver operating characteristic curve (AUC) of LBP were pooled using the Hierarchical Summary Receiver Operating Characteristic (HSROC) method. Results Our search returned 53 reports, of which 8 fulfilled the inclusion criteria, accounting for 1684 patients. The pooled sensitivity and specificity of LBP for diagnosis of sepsis by the HSROC method were 0.64 (95% CI: 0.56-0.72) and 0.63 (95% CI: 0.53-0.73), respectively. The value of the DOR was 3.0 (95% CI: 2.0-4.0) and the AUC was 0.68 (95% CI: 0.64-0.72). Meta-regression analysis revealed that cut-off values accounted for the heterogeneity of sensitivity and sample size (> = 150) accounted for the heterogeneity of specificity. Conclusions Based on the results of our meta-analysis, LBP had weak sensitivity and specificity in the detection of sepsis. LBP may not be practically recommended for clinical utilization as a single biomarker.

Original languageEnglish
Article numbere0153188
JournalPLoS ONE
Volume11
Issue number4
DOIs
StatePublished - 04 2016

Bibliographical note

Publisher Copyright:
© 2016 Chen et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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