The Accuracy of Mean Neutrophil Volume Relative to Blood Culture for the Diagnosis of Sepsis: A Meta-analysis
Keywords:Mean Neutrophil Volume, sepsis, accuracy, blood culture
Background. Sepsis is difficult to diagnose clinically because the signs and symptoms are non-specific. Blood culture is the gold standard, but it has low sensitivity and it takes at least 24-48 hours before results are released. Cell population data such as mean neutrophil volume (MNV) has recently has been shown to be significantly increased in septic patients both with high WBC and normal/low WBC count.
Objective. The aim of the present study was to conduct a meta-analysis of published papers on the accuracy of MNV in diagnosing sepsis relative to blood culture.
Methodology. Electronic databases including PubMed/Medline, Elsevier/Scopus, and Google Scholar were reviewed. Papers that were not retrieved in full text and papers that do not have data on MNV were excluded. The sensitivity and specificity were pooled, and the area under the receiver operating characteristic curve (AUROC) is computed.
Results. Seven studies including 994 participants were included in the meta-analysis. With a mean cut-off value of 153.15 fL [149.1315, 157.1685], the pooled sensitivity and specificity were 0.82 [0.71, 0.89], and 0.78 [0.68, 0.86] respectively. The AUROC is 0.87 [0.83-0.89].
Conclusion. MNV is a potential indicator for sepsis with high specificity and sensitivity, with moderate to high test accuracy. GRADE evaluation indicated a moderate quality of evidence: despite the large effect size, there is a serious risk of bias and high heterogeneity between the included studies.
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