The Role of IL-6 for Predicting Neonatal Sepsis: A Systematic Review and Meta-Analysis

AUTHORS

Gholamreza Roshandel 1 , Ali Ahani 2 , Arezou Mirfazeli 2 , Lobat Shahkar 3 , Abbasali Keshtkar 4 , *

1 Digestive Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Pediatrics, Golestan University of Medical Sciences, Gorgan, Iran

3 Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan Department of Pediatrics, Golestan University of Medical Sciences, Gorgan, Iran

4

How to Cite: Roshandel G, Ahani A, Mirfazeli A, Shahkar L, Keshtkar A. The Role of IL-6 for Predicting Neonatal Sepsis: A Systematic Review and Meta-Analysis, Iran J Pediatr. 2011 ; 21(4):411-417.

ARTICLE INFORMATION

Iranian Journal of Pediatrics: 21 (4); 411-417
Published Online: December 31, 2010
Article Type: Review Article
Received: June 28, 2010
Accepted: November 13, 2010

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Abstract

Objective: Neonatal sepsis (NS) is a common and life-threatening disorder in infants. Previous studies showed that interleukin-6 (IL-6) may be a valid non-invasive and rapid method for diagnosis of NS. We conducted this review to assess the validity of IL-6 for predicting NS.
Methods: This was a systematic review with meta-analysis. Embase, Medline and Web of Science databases were searched between January 1990 and December 2009. The search terms used were “cytokine”, “neonate”, “sepsis” and “interleukin-6". We used standard methods recommended for meta analyses of diagnostic test evaluations. The analysis was based on a summary ROC (SROC) curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. Potential presence of publication bias was tested using funnel plots and the Egger test.
Findings: Meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. The pooled sensitivity and specificity of IL-6 was 0.79 and 0.84, respectively. The maximum joint sensitivity and specificity (i.e., the Q value) in SROC curve was 0.82 and the area under curve (AUC) was 0.89 (95% CI: 0.84-0.94). Meta-regression analysis showed that the diagnostic accuracy of IL-6 was not affected by confounding variables. The evaluation of publication bias showed that the Egger test was not significant (P=0.07).
Conclusion: IL-6 seems to be a valid marker for predicting NS. It may be considered for early diagnosis of sepsis in neonatal care units.

Keywords

Interlukin-6 Cytokines Sepsis Neonate Meta-analysis

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