Table 1 Characteristics of included studies in review
First author | Year | Study design | Patient sampling | Country | Timeframe | Single-center or multicenter | Main objective | Type of surgery | Timing of surgery | Clinical problem /Target condition | Reference standard (criteria for diagnosis of infection) | Independence of judgment for index test without knowing reference standard results | Independence of judgment for reference standard without knowing index test results | Index tests | Flow and timing of test | No. Patients | No. Patients with Infection vs no. Patients without infection |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Chakravarthy [79] | 2015 | Observational with prospective data collection | Not specified | India | 2013 | Single-center | To determine the ability of elevated PCT levels to identify bacterial infections in cardiac surgical patients | Cardiac surgery | Elective | Infection | Positive cultures | Not specified | Not specified | PCT | Not specified | 819 | 43 vs 776 |
Chen [80] | 2022 | Observational with prospective data collection | Consecutive | China | 2020–2021 | Single-center | To assess the value of IL-6 in the diagnosis of early pneumonia after CCH and compare it with that of PCT, CRP and WBC counts | Cardiac surgery with CPB | Elective | Pulmonary infection | Positive cultures, positive radiogram, clinical signs, laboratory findings | Not specified | Not specified | PCT, IL-6, CRP, and WBC count | Daily on POD 1 through 5 | 694 | 68 vs 626 |
de la Varga-MartÃnez [81] | 2022 | Observational with prospective data collection | Consecutive | Spain | 2012–2016 | Single-center | To evaluate the behavior of PCT and its usefulness in the diagnosis of postoperative pulmonary infection after Cardiac surgery in patients with or without impaired renal function | Heart valve surgery with CPB | Not specified | Pulmonary infection | Centers for Disease Control and Prevention definitions | Not specified | Not specified | PCT, CRP | ICU admission and at 8, 16, 24 and 72 h | 803 | 42 vs 761 |
Jin [82] | 2021 | Observational with prospective data collection | Consecutive | China | 2020–2021 | Single-center | To investigate the ability of PCT variation to diagnose postoperative pneumonia after Cardiac surgery | Cardiac surgery with CPB | Elective | Pulmonary infection | Positive cultures, positive radiogram, clinical signs | Not specified | Two independent experts blinded to PCT, CRP and WBC count | PCT, WBC count and CRP | Before surgery, ICU admission, and daily on POD 1 through 5 | 272 | 24 vs 248 |
Li [83] | 2021 | Observational with retrospective data collection | Not specified | China | Not specified | Single-center | To investigate the early predictive value of PCT for the diagnosis of pulmonary infections after off-pump coronary artery bypass grafting | Off-pump coronary artery bypass grafting | Elective | Pulmonary infection | Centers for Disease Control and Prevention definitions | Not specified | Not specified | PCT, CRP, WBC | POD 1 | 131 | 23 vs 108 |
Liu [84] | 2019 | Observational with retrospective data collection | Consecutive | China | 2015–2017 | Single-center | To evaluate the value of PCT in diagnosing EPOP after off-pump CABG | First-time isolated off-pump CABG | Elective and urgent | Early postoperative pneumonia (within 3 days after CABG) | Positive cultures, positive radiogram, clinical signs, laboratory findings | Not specified | Not specified | PCT, WBC, neutral granulocyte ratio | POD 1 | 402 | 44 vs 358 |
Miao [17] | 2022 | Observational with retrospective data collection | Not specified | China | 2019–2020 | Single-center | To evaluate the value of dynamic monitoring of PCT as a biomarker for the early diagnosis of postoperative infections in patients undergoing cardiac surgery | Cardiac surgery with CPB | Not specified | Infection | Positive cultures | Not specified | Not specified | PCT | on POD 1, 3, and 5 | 210 | 41 vs 169 |
Sharma [85] | 2016 | Observational with prospective data collection | Consecutive | India | 2015 | Single-center | To compare the efficacy of PCT with WBC in predicting infection after CPB surgery. To assess the prognostic significance of PCT levels on the postoperative day 1 | Cardiac surgery with CPB | Elective | Infection | Positive cultures | Not specified | Not specified | PCT, WBC count | POD 1 | 100 | 20 vs 80 |
Wang [86] | 2017 | Observational with retrospective data collection | Not specified | China | 2014–2017 | Single-center | To determine the value of PCT as an early marker of postoperative infection after Cardiac surgery with CPB | Cardiac surgery with CPB | Not specified | Infection | Centers for Disease Control and Prevention definitions | Not specified | Not specified | PCT | ICU admission, POD 1, 3, and 5 | 82 | 25 vs 57 |
Zhu [87] | 2014 | Observational with retrospective data collection | Not specified | China | 2009–2012 | Single-center | To investigate the changes in mean neutrophil volume before and after surgery, called ΔMNV; to compare the ΔMNV with PCT and CRP in terms of diagnostic sensitivity and specificity for postsurgical bacterial infection | Cardiac surgery | Not specified | Infection | Positive cultures, clinical signs, laboratory findings | Not specified | Not specified | PCT, CRP, Neutrophil CPD, WBC count and neutrophil percentage | POD 2 and 3 | 250 | 31 vs 219 |
Zou [88] | 2018 | Observational with prospective data collection | Consecutive | China | 2017 | Single-center | To explore the role of serum intestinal fatty acid-binding protein (IFABP) as a predictor of prognosis in postoperative Cardiac surgical patients | Heart valve surgery and/or coronary artery bypass graft | Not specified | Infection | Positive cultures, positive radiogram, clinical signs | Not specified | Not specified | PCT, IFABP | ICU admission | 40 | 12 vs 28 |