Biomarkers for pneumonia after major trauma: A systematic review and meta-analysis
Abstract
Background: Major trauma is a significant global health issue. Pneumonia poses an additional risk for morbidity and mortality after major trauma yet identifying pneumonia remains challenging in clinical practice. This systematic review aims to evaluate blood-based biomarkers for pneumonia in major trauma patients. Methods: The search was performed across four databases up to November 18th 2024, including primary studies investigating blood-based biomarkers associated with pneumonia in adults hospitalised after major trauma (PROSPERO CRD42024542059). Risk of bias was assessed using the ROBINS-E tool and meta-analysis was performed of pooled data. Results: Among 20 included studies, with a total of 4316 participants, the pooled mean pneumonia rate was 32.7% (23.5%–43.4%). Seventy biomarkers for post-operative pneumonia were identified, with meta-analysis possible for 12 of the reported biomarkers. At admission interleukin (IL)-6 (standardised mean difference: 1.41 (0.04–2.77), p = 0.04), cytokeratin fragment 21-1 (CYFRA21-1; 0.53 (0.19–0.86), p = 0.002) and leucocyte count (0.28 (0.05–0.50), p = 0.01) were higher in patients who developed pneumonia. During hospitalisation, patients with pneumonia had significantly higher IL-10 (4.42 (3.89–4.95), p > 0.001) and neutrophil oxidative burst capacity (1.52 (0.96–2.09), p > 0.001) at day 1, CYFRA21-1 at day 2 (0.43 (0.10–0.76), p = 0.01), IL-6 at day 3 (3.11 (2.66–3.55), p > 0.001) and day 5 (0.57 (0.05–1.09), p = 0.03) and CRP at…
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Evidence Hub reads this as a meta-analysis, done in people. 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: 4,316 participants or records.
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