Presepsin Versus CRP and Procalcitonin as Biomarker of Sepsis: A meta-analysis

Background: Despite advances in therapy, sepsis is the leading cause of death in critical care settings, so early diagnosis of sepsis is a must, so we performed a meta-analysis to compare the accuracy of presepsin versus CRP and procalcitonin as biomarker of sepsis. Methods: This analysis performed using MEDLINE, EMBASE, PubMed and Cochrane to identify all published randomized, and prospective clinical trials, comparing the accuracy of Presepsin versus Procalcitonin and CRP in diagnosis of sepsis. Results: The Database of our meta-analysis included 13 studies with 2679 participants meeting definitive criteria of sepsis, The pooled sensitivity and of presepsin, procalcitonin and CRP was 0.84, 0.80, 0.69 respectively which shows that presepsin is stronger than procalcitonin and CRP, the pooled specificity of presepsin, procalcitonin, CRP was 0.73, 0.69, 0.68 respectively. The PLR and NLR of presepsin were 2.7 and 0.2, respectively and of procalcitonin were 2.6 and 0.29, respectively and of CRP were 2.6 and 0.41, respectively. The DOR of presepsin, procalcitonin and CRP was 11.8, 8.8, 6.2, respectively. Conclusions: This study demonstrated that presepsin is a reliable biomarker of sepsis because of its higher sensitivity and specificity than procalcitonin and CRP.