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

Gholamreza Roshandel; Ali Ahani; Arezou Mirfazeli; Lobat Shahkar; Abbasali Keshtkar

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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

Author(s):

Gholamreza Roshandel¹,

Ali Ahani²,

Arezou Mirfazeli²,

Lobat Shahkar³,

Abbasali Keshtkar^4,*

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

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

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

IJ Pediatrics:Vol. 21, issue 4; 411-417

Published online:Dec 31, 2010

Article type:Review Article

Received:Jun 28, 2010

Accepted:Nov 13, 2010

How to Cite:Gholamreza RoshandelAli AhaniArezou MirfazeliLobat ShahkarAbbasali KeshtkarThe Role of IL-6 for Predicting Neonatal Sepsis: A Systematic Review and Meta-Analysis.Iran J Pediatr.21(4):411-417.

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.

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