The accuracy of soluble urokinase-type plasminogen activator receptor for the diagnosis of neonatal sepsis: a meta-analysis

Jinjin Ma; Xinqing Chen; Xiaoyan Wang; Jiaojiao Liang; Liyan Guo; Yan Su; Ling Hao; Changjun Ren

doi:10.3389/fmed.2023.1169114

The accuracy of soluble urokinase-type plasminogen activator receptor for the diagnosis of neonatal sepsis: a meta-analysis

Front Med (Lausanne). 2023 Apr 27:10:1169114. doi: 10.3389/fmed.2023.1169114. eCollection 2023.

Authors

Jinjin Ma¹, Xinqing Chen¹, Xiaoyan Wang¹, Jiaojiao Liang¹, Liyan Guo¹, Yan Su¹, Ling Hao¹, Changjun Ren¹

Affiliation

¹ Department of Pediatrics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

Abstract

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in newborns. However, atypical clinical manifestations and symptoms make the early diagnosis of neonatal sepsis a challenge. Relatively high-serum soluble urokinase-type plasminogen activator receptor (suPAR) has been implicated as a diagnostic biomarker for adult sepsis. Therefore, the meta-analysis is intended to explore the diagnostic value of suPAR for neonatal sepsis.

Methods: The PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, China Biological Medicine Disk, and Wanfang databases were retrieved from inception to 31 December 2022 to collect diagnostic accuracy studies about suPAR for neonatal sepsis. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool. Then, a meta-analysis was performed using Stata 15.0 software.

Results: A total of six articles involving eight studies were included. The results of the meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.89 [95%CI (0.83-0.93)], 0.94 [95%CI (0.77-0.98)], 14 [95%CI (3.5-55.2)], 0.12 [95%CI (0.08-0.18)], and 117 [95%CI (24-567)], respectively. The area under the curve (AUC) of summary receiver operator characteristic (SROC) curves was 0.92 [95%CI (0.90-0.94)]. Sensitivity analysis confirmed the stability of the results, and publication bias was not observed. Fagan's nomogram results demonstrated the clinical availability of the findings.

Conclusion: Current evidence suggests that suPAR has potential diagnostic value for neonatal sepsis. Owing to the limited quality of the included studies, more high-quality studies are needed to verify the above conclusion.

Keywords: diagnosis; meta-analysis; neonatal sepsis; soluble urokinase-type plasminogen activator receptor; suPAR.

Publication types

Review