Background: Bacterial peritonitis is serious disease and remains a diagnostic challenge for clinicians. Many studies\nhave highlighted the potential usefulness of procalcitonin (PCT) for identification of bacterial peritonitis, however,\nthe overall diagnostic value of PCT remains unclear. Therefore, we performed a meta-analysis to assess the accuracy\nof PCT for detection of bacterial peritonitis.\nMethods: We performed a systematic searched in MEDLINE, EMBASE, SCOPUS, China Biology Medicine Database\n(CBM), China National Knowledge Infrastructure Database (CNKI) and Cochrane databases for trials that evaluated\nthe diagnostic role of PCT for bacterial peritonitis. Sensitivity, specificity and other measures of accuracy of PCT\nwere pooled using bivariate random effects models.\nResults: Eighteen studies involving 1827 patients were included in the present meta-analysis. The pooled sensitivity\nand specificity of serum PCT for the diagnosis bacterial peritonitis were 0.83 (95% CI: 0.76ââ?¬â??0.89) and 0.92 (95% CI:\n0.87ââ?¬â??0.96), respectively. The positive likelihood ratio was 11.06 (95% CI: 6.31ââ?¬â??19.38), negative likelihood ratio was\n0.18 (95% CI: 0.12ââ?¬â??0.27) and diagnostic odds ratio (DOR) was 61.52 (95% CI: 27.58ââ?¬â??137.21). The area under the\nreceiver operating characteristic curve (AUROC) was 0.94. Use of a common PCT cut-off value could improve the\nDOR to 75.32 and the AUROC to 0.95. Analysis of the seven studies that measured serum C-reactive protein (CRP)\nindicated that PCT was more accurate than CRP for the diagnosis of bacterial peritonitis.\nConclusions: Our results indicate that PCT determination is a relatively sensitive and specific test for the diagnosis\nof bacterial peritonitis. However, with regard to methodological limitations and significant heterogeneity, medical\ndecisions should be based on both clinical findings and PCT test results.
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