Diagnosis Value of Soluble Triggering Receptor Expressed on Myeloid Cells-1 for Ventilator-Associated Pneumonia:A Systematic Review

Objective To evaluate the accuracy of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) as a diagnostic index for ventilator-associated pneumonia(VAP).Methods We searched the PubMed,EMBase,Cochrane Library,Wanfang Database,CNKI and VIP for clinical trials which assessed the diagnosis accuracy of sTREM-1 for VAP.The methodological quality of each study was assessed by the quality assessment for studies of diagnostic accuracy(QUADAS) tool.The Meta-disc software was used to conduct merger analyses on sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio.The heterogeneity test was performed and summary receiver operating characteristic(SROC) curve was completed.Results 8 studies were included(180 VAP patients and 224 non-VAP patients).The value of merger sensitivity,specificity,and diagnostic odds ratio were 0.80,0.74,and 13.89,respectively.The area under of SROC curve was 0.857,with Q* point at 0.788.Conclusion sTREM-1 showed moderate accuracy for VAP diagnosis in adult mechanically ventilated patients,which should be combined with other diagnostic markers to further improve the sensitivity and specificity.