Diagnostic accuracy of serum procalcitonin for intracranial infection in adults: A systematic review and meta-analysis
Hui Du, Chunyu Tan, Jiawei Liu, Pengfei Li, Jun WangBackground:
Intracranial infections such as meningitis and brain abscesses remain difficult to diagnose early because of their nonspecific clinical presentation. Serum procalcitonin (PCT) has been identified as a promising biomarker for bacterial infections, but its diagnostic value in intracranial infections is not well defined. To systematically evaluate the diagnostic accuracy of serum PCT for detecting intracranial infections in adults.
Methods:
A meta-analysis of 10 studies was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases including PubMed, Scopus, Medline, and ClinicalTrials.gov were searched. Pooled sensitivity, specificity, and diagnostic accuracy were calculated using a random-effects model.
Results:
The pooled sensitivity of serum PCT for diagnosing intracranial infections was 83% (95% confidence interval: 76–89), and the pooled specificity was 78% (95% confidence interval: 69–86). The summary receiver operating characteristic curve yielded an area under the curve of 0.86, indicating moderate diagnostic accuracy. Heterogeneity was moderate (
Conclusion:
Serum PCT shows moderate diagnostic accuracy for intracranial infections and can support, but not replace, standard diagnostic methods such as cerebrospinal fluid analysis and neuroimaging. Its greatest value lies in integration into a multimodal diagnostic strategy. Further prospective studies are warranted to define standardized cutoff values and optimize its clinical application.