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Procalcitonin and biomarkers for stroke-associated pneumonia: a systematic review and meta-analysis

Yuan Wang, Ting-Ting Wang, Shouqin Hu, Yun-Chien Cheng, Chong-Bo Du, Guolong Xu

BMC Pulmonary Medicine, 2025

1,478 participants · 7 citations

Abstract

Stroke-associated pneumonia (SAP) is a common and severe complication following stroke, significantly impacting recovery and outcomes. Early identification of biomarkers and development of predictive models are essential for SAP diagnosis and prevention. This study systematically evaluated the diagnostic value of procalcitonin (PCT) and other biomarkers for SAP and explored their integration into predictive models. A systematic review and meta-analysis were conducted by searching PubMed, Web of Science, and CNKI databases for studies published up to March 2023. Inclusion criteria focused on studies reporting biomarkers for SAP diagnosis and predictive models. Statistical analyses included pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) using RevMan 5.4 and R software. This meta-analysis included 11 studies with 1,478 patients and found that PCT levels were significantly elevated in SAP patients, particularly those with ischemic stroke (standardized mean difference [SMD] = 2.89, 95% confidence interval [CI] = 1.74–4.04). PCT demonstrated high diagnostic accuracy, with a pooled sensitivity of 0.84, specificity of 0.89, DOR of 48.78, and AUC of 0.91, outperforming other biomarkers like CRP and IL-6. Predictive models incorporating biomarkers improved risk stratification, though heterogeneity among studies underscores the need for standardization. PCT is a reliable biomarker for SAP diagnosis,…

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Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,478 participants or records.

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