Plasminogen Activator Inhibitor 1 for Predicting Sepsis Severity and Mortality Outcomes: A Systematic Review and Meta-Analysis
Plasminogen activator inhibitor-1 (PAI-1), a crucial regulator of fibrinolysis, is increased in sepsis, but its values in predicting disease severity or mortality outcomes have been controversial. Therefore, we conducted a systematic review and meta-analysis of its predictive values in sepsis.
MethodsPubMed and Embase were searched until August 18, 2017 for studies that evaluated the relationships between PAI-1 levels and disease severity or mortality in sepsis.
ResultsA total of 112 and 251 entries were retrieved from the databases, of which 18 studies were included in the final meta-analysis. A total of 4,467 patients (36% male, mean age: 62 years, mean follow-up duration: 36 days) were analyzed. PAI-1 levels were significantly higher in non-survivors than survivors [odds ratios (OR): 3.93, 95% confidence interval (CI): 2.31–6.67, P < 0.0001] and in patients with severe sepsis than in those less severe sepsis (OR: 3.26, 95% CI: 1.37–7.75, P = 0.008).
ConclusionPAI-1 is a significant predictor of disease severity and all-cause mortality in sepsis. Although the predictive values of PAI-1 reached statistical significance, the clinical utility of PAI-1 in predicting outcomes will require carefully designed prospective trials.
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REFERENCES
- https://doi.org//10.1001/jama.2016.0287
- https://doi.org//10.1055/s-0037-1616084
- https://doi.org//10.1152/ajplung.00312.2002
- https://doi.org//10.1002/ajh.20089
- https://doi.org//10.1016/j.thromres.2005.06.007
- https://doi.org//10.1111/j.1538-7836.2007.02796.x
- https://doi.org//10.1007/s00134-010-1752-5
- https://doi.org//10.1186/cc9290
- https://doi.org//10.1111/j.1365-3156.2009.02434.x
- https://doi.org//10.1097/SHK.0b013e31821e4e04
- https://doi.org//10.1007/s00134-012-2730-x
- https://doi.org//10.2169/internalmedicine.52.0571
- https://doi.org//10.1186/cc13190
- https://doi.org//10.1016/j.thromres.2014.04.013
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AUTHORS (13)
CATEGORIES
- Transplantation Immunology
- Tumour Immunology
- Immunology not elsewhere classified
- Immunology
- Veterinary Immunology
- Animal Immunology
- Genetic Immunology
- Applied Immunology (incl. Antibody Engineering, Xenotransplantation and T-cell Therapies)
- Autoimmunity
- Cellular Immunology
- Humoural Immunology and Immunochemistry
- Immunogenetics (incl. Genetic Immunology)
- Innate Immunity