Association Between Serum Levels of Procalcitonin and Clinical Outcomes in Traumatic Brain Injury Patients: A Systematic Review with Meta-analysis
Mirian Castaneda Perez1, Leonardo Arquinigo Tixe1, Guillermo Mantilla Chachico1, Miguel Cabanillas-Lazo3, Carlos Rodrigo Vicuña2
1Lima, Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, 2Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, 3Lima, Grupo de Investigación Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria (NEMECS), Universidad Científica del Sur, Lima, Perú
Objective:
To evaluate the association between serum procalcitonin (PCT) levels and clinical outcomes in traumatic brain injury (TBI) patients through a systematic review and meta-analysis. Specifically, we aim to assess whether PCT can serve as a prognostic biomarker for predicting mortality and complications in TBI patients.
Background:
Traumatic brain injury (TBI) is a major global cause of morbidity and mortality. Emerging evidence links serum biomarkers like procalcitonin (PCT), an inflammatory marker, to TBI severity and outcomes. We conducted a systematic review and meta-analysis to assess the association between PCT levels and clinical outcomes in TBI patients.
Design/Methods:
We conducted a systematic search of multiple databases (PubMed, Embase, Scopus, Web of Science, and Google Scholar) up to July 2024 to identify studies assessing serum procalcitonin (PCT) levels in patients with traumatic brain injury (TBI). A meta-analysis using a random-effects model was performed to estimate pooled effects for relevant outcomes, and a narrative synthesis was provided when meta-analysis was not feasible. Subgroup and sensitivity analyses were also conducted. The certainty of evidence for each outcome was evaluated using GRADE criteria.
Results:
After the selection of 420 studies, we included 12 studies. PCT value is a good biomarker to assess complications such as mortality in patients with severe brain trauma (AUC: 0.83; 12 studies; 1222 participants; 95% CI: 0.75 to 0.91; I2 = 87.14%; CoE low). All studies had a low risk of bias.
Conclusions:
Procalcitonin (PCT) levels are moderately higher in traumatic brain injury (TBI) patients compared to healthy controls. PCT shows potential as a prognostic marker for predicting mortality and secondary infections, with low to moderate certainty. While promising, further research is needed to confirm its clinical utility in TBI patients.
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