Meta-analysis of the effect of procalcitonin on anti-infection treatment in the elderly
10.3760/cma.j.issn.0254-9026.2023.06.020
- VernacularTitle:降钙素原在老年人群抗感染治疗中指导作用的荟萃分析
- Author:
Chenshuang ZOU
1
;
Yan ZHANG
;
Pulin YU
Author Information
1. 北京医院 老年医学研究中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Procalcitonin;
Anti-infection;
Prognosis
- From:
Chinese Journal of Geriatrics
2023;42(6):733-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of procalcitonin(PCT)guiding anti-infection therapy on the prognosis of elderly patients.Methods:By searching PubMed, EMBASE database, Cochrane library, Cochrane clinical trial center registry and SinoMed database in Chinese, we searched for a randomized controlled clinical(RCT)study on the effect of PCT-guided anti-infection treatment on the prognosis of elderly patients, which was conducted according to the PRISMA statement.The main purpose of the study was to evaluate the time of antibiotic application.Results:After retrieval, 9 RCT clinical studies were finally included, involving 2 702 elderly patients, with an average follow-up of 3.5 months(1-12 months). The average age was(71.3±8.9)years old, with 52.8% of males and baseline levels of white blood cell(WBC)was 12.9×10 9/L, C-reactive protein(CRP)was 18.9 mg/L, PCT was 0.38 μg/L.Compared with conventional anti-infective therapy, PCT-guided anti-infective therapy can reduce the antibiotic application time of elderly patients[standard mean difference( SMD)=-2.39 days, 95% CI(-4.03, -0.75)days, P=0.004]. However, PCT-guided anti-infection treatment had no significant effect on the length of hospital stay[ SMD=-0.46 d, 95% CI(-0.05, 0.14)d, P=0.135], the rate of reinfection[ RR=0.87, 95% CI(0.73, 1.03), P=0.105]and the risk of all-cause death[ RR=1.02, 95% CI(0.80, 1.31), P=0.863]. Conclusions:PCT-guided anti-infection treatment can reduce the time of antibiotic application in elderly patients, but other clinical effects need to be verified by more large-scale studies
